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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gastrointestinal Hemorrhage With Mcc","code_information":[{"code":"377","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10978.9,"maximum":26879.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26879.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13723.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16798.33},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20583.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13723.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24485.03},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13723.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13998.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13723.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13723.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10978.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13723.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13723.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13723.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25405.98},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13723.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13601.58,"10th_percentile":13601.58,"90th_percentile":13601.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28536.13,"10th_percentile":28536.13,"90th_percentile":29576.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13341.4,"10th_percentile":13341.4,"90th_percentile":13342.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":20626.9,"10th_percentile":20626.9,"90th_percentile":20626.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":7716.05,"10th_percentile":7716.05,"90th_percentile":7716.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":13552.91,"10th_percentile":7116.79,"90th_percentile":13562.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14350.14,"10th_percentile":14350.14,"90th_percentile":14350.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":25617.59,"10th_percentile":25617.59,"90th_percentile":25617.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13287.17,"10th_percentile":13287.17,"90th_percentile":13287.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gastrointestinal Hemorrhage With Cc","code_information":[{"code":"378","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5890.04,"maximum":14431.12,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14431.12},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7362.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9018.6},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11050.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7362.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13145.39},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7362.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7509.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7362.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7362.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5890.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7362.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7362.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7362.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13639.83},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7362.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":8901.88,"10th_percentile":8901.88,"90th_percentile":8901.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7279.55,"10th_percentile":7279.55,"90th_percentile":46009.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17987.18,"10th_percentile":8974.76,"90th_percentile":30592.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6648.66,"10th_percentile":5617.5,"90th_percentile":7157.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":10144.87,"10th_percentile":10144.87,"90th_percentile":10329.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"16","median_amount":7271.65,"10th_percentile":3118.44,"90th_percentile":7289.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2982.64,"10th_percentile":2982.64,"90th_percentile":2982.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":1274.0,"10th_percentile":1274.0,"90th_percentile":1274.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7015.42,"10th_percentile":6990.7,"90th_percentile":7139.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gastrointestinal Hemorrhage Without Cc/Mcc","code_information":[{"code":"379","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3786.16,"maximum":9458.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9458.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4732.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5910.78},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7242.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4732.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8615.48},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4732.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4827.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4732.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4732.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3786.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4732.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4732.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4732.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8939.53},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4732.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2710.89,"10th_percentile":2710.89,"90th_percentile":2710.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8733.2,"10th_percentile":8733.2,"90th_percentile":8733.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4674.67,"10th_percentile":4674.67,"90th_percentile":4674.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":370.0,"10th_percentile":370.0,"90th_percentile":370.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complicated Peptic Ulcer With Mcc","code_information":[{"code":"380","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11784.9,"maximum":28531.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28531.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14731.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17830.56},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21848.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14731.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25989.6},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14731.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15025.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14731.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14731.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11784.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14731.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14731.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14731.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26967.14},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14731.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4739.16,"10th_percentile":4739.16,"90th_percentile":4739.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complicated Peptic Ulcer With Cc","code_information":[{"code":"381","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6507.46,"maximum":16069.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16069.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8134.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10042.49},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12305.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8134.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14637.8},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8134.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8297.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8134.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8134.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6507.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8134.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8134.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8134.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15188.37},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8134.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19917.44,"10th_percentile":19917.44,"90th_percentile":20425.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":948.49,"10th_percentile":948.49,"90th_percentile":948.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complicated Peptic Ulcer Without Cc/Mcc","code_information":[{"code":"382","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4808.37,"maximum":10798.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10798.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6010.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6748.43},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8269.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6010.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9836.42},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6010.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6130.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6010.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6010.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4808.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6010.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6010.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6010.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10206.4},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6010.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uncomplicated Peptic Ulcer With Mcc","code_information":[{"code":"383","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8292.42,"maximum":20060.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20060.93},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10365.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12536.9},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15361.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10365.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18273.62},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10365.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10572.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10365.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10365.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8292.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10365.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10365.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10365.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18960.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10365.53,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uncomplicated Peptic Ulcer Without Mcc","code_information":[{"code":"384","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5133.9,"maximum":12555.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12555.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7846.45},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9614.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11436.88},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6545.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5133.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11867.06},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6417.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":9003.61,"10th_percentile":9003.61,"90th_percentile":9003.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":129.89,"10th_percentile":129.89,"90th_percentile":129.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inflammatory Bowel Disease With Mcc","code_information":[{"code":"385","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9503.23,"maximum":23041.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23041.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11879.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14399.36},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17644.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11879.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20988.32},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11879.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12116.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11879.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11879.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9503.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11879.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11879.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11879.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21777.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11879.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":36877.92,"10th_percentile":36877.92,"90th_percentile":36877.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":20451.23,"10th_percentile":20451.23,"90th_percentile":20451.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inflammatory Bowel Disease With Cc","code_information":[{"code":"386","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5863.62,"maximum":14299.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14299.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7329.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8936.13},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10949.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7329.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13025.19},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7329.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7476.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7329.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7329.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5863.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7329.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7329.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7329.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13515.1},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7329.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10129.11,"10th_percentile":10129.11,"90th_percentile":12910.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inflammatory Bowel Disease Without Cc/Mcc","code_information":[{"code":"387","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4091.86,"maximum":9581.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9581.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5114.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5987.69},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7336.95},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5114.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8727.58},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5114.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5217.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5114.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5114.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4091.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5114.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5114.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5114.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9055.85},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5114.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9708.53,"10th_percentile":9708.53,"90th_percentile":12843.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":7705.85,"10th_percentile":7705.85,"90th_percentile":7705.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":10168.4,"10th_percentile":10168.4,"90th_percentile":10168.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gastrointestinal Obstruction With Mcc","code_information":[{"code":"388","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8869.6,"maximum":21804.59,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21804.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11087.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13626.58},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16697.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11087.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19861.92},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11087.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11308.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11087.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11087.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8869.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11087.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11087.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11087.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20608.99},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11087.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24923.28,"10th_percentile":24923.28,"90th_percentile":24923.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10992.13,"10th_percentile":10992.13,"90th_percentile":10992.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10757.42,"10th_percentile":10757.42,"90th_percentile":10767.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gastrointestinal Obstruction With Cc","code_information":[{"code":"389","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4743.5,"maximum":11697.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11697.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5929.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7309.95},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8957.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5929.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10654.88},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5929.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6047.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5929.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5929.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4743.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5929.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5929.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5929.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11055.64},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5929.38,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":5855.63,"10th_percentile":2710.89,"90th_percentile":5864.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10058.9,"10th_percentile":4729.68,"90th_percentile":16492.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5314.79,"10th_percentile":5314.79,"90th_percentile":5764.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":6042.72,"10th_percentile":6042.72,"90th_percentile":6042.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5865.63,"10th_percentile":5861.63,"90th_percentile":5891.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":182.95,"10th_percentile":182.95,"90th_percentile":182.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":11787.77,"10th_percentile":11787.77,"90th_percentile":11787.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5757.82,"10th_percentile":5750.56,"90th_percentile":5770.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gastrointestinal Obstruction Without Cc/Mcc","code_information":[{"code":"390","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3267.24,"maximum":8011.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8011.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4084.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5006.42},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6134.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4084.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7297.29},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4084.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4165.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4084.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4084.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3267.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4084.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4084.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4084.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7571.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4084.05,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":8065.89,"10th_percentile":8065.89,"90th_percentile":8065.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4050.1,"10th_percentile":4050.1,"90th_percentile":4057.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7752.0,"10th_percentile":7752.0,"90th_percentile":7752.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":2792.0,"10th_percentile":2792.0,"90th_percentile":2792.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4041.26,"10th_percentile":326.55,"90th_percentile":4057.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":7623.62,"10th_percentile":7623.62,"90th_percentile":8119.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3973.95,"10th_percentile":3969.78,"90th_percentile":3987.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc","code_information":[{"code":"391","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7617.36,"maximum":18369.17,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18369.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9521.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11479.65},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14066.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9521.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16732.58},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9521.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9712.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9521.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9521.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7617.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9521.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9521.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9521.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17361.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9521.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9403.26,"10th_percentile":9298.14,"90th_percentile":9416.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16445.31,"10th_percentile":15804.69,"90th_percentile":17573.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8224.48,"10th_percentile":8224.48,"90th_percentile":8224.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":16392.78,"10th_percentile":16392.78,"90th_percentile":16392.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":4435.51,"10th_percentile":4435.51,"90th_percentile":4435.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9404.15,"10th_percentile":1200.0,"90th_percentile":9427.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9220.7,"10th_percentile":9218.88,"90th_percentile":9262.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc","code_information":[{"code":"392","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4682.25,"maximum":11335.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11335.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5852.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7083.86},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8680.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5852.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10325.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5852.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5969.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5852.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5852.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4682.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5852.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5852.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5852.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10713.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5852.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":5784.15,"10th_percentile":5780.01,"90th_percentile":9632.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":2710.89,"10th_percentile":395.0,"90th_percentile":5803.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"1 through 10","median_amount":5702.77,"10th_percentile":5702.77,"90th_percentile":5702.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"41","median_amount":8977.21,"10th_percentile":4513.97,"90th_percentile":14709.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5039.8,"10th_percentile":4149.8,"90th_percentile":5689.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":9076.33,"10th_percentile":6981.23,"90th_percentile":10076.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2283.34,"10th_percentile":2283.34,"90th_percentile":2283.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"21","median_amount":5781.35,"10th_percentile":797.63,"90th_percentile":5816.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":356.69,"10th_percentile":356.69,"90th_percentile":356.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1710.36,"10th_percentile":1710.36,"90th_percentile":1710.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3701.72,"10th_percentile":1960.64,"90th_percentile":3701.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"12","median_amount":10925.31,"10th_percentile":722.81,"90th_percentile":11635.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"15","median_amount":280.59,"10th_percentile":130.0,"90th_percentile":5689.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System Diagnoses With Mcc","code_information":[{"code":"393","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9605.33,"maximum":23540.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23540.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12006.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14711.63},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18026.75},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12006.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21443.48},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12006.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12246.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12006.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12006.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9605.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12006.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12006.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12006.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22250.03},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12006.66,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6824.99,"10th_percentile":6824.99,"90th_percentile":11867.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22790.03,"10th_percentile":22790.03,"90th_percentile":22790.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":2792.0,"10th_percentile":2792.0,"90th_percentile":2792.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":4435.51,"10th_percentile":4435.51,"90th_percentile":4435.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9428.26,"10th_percentile":9428.26,"90th_percentile":9428.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11624.81,"10th_percentile":11624.81,"90th_percentile":11624.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System Diagnoses With Cc","code_information":[{"code":"394","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5619.78,"maximum":13682.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13682.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7024.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8550.66},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10477.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7024.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12463.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7024.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7165.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7024.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7024.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5619.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7024.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7024.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7024.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12932.12},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7024.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6937.33,"10th_percentile":6937.33,"90th_percentile":6937.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11001.72,"10th_percentile":9707.89,"90th_percentile":15869.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5929.07,"10th_percentile":5929.07,"90th_percentile":6686.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":9855.73,"10th_percentile":9855.73,"90th_percentile":12093.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6939.33,"10th_percentile":949.13,"90th_percentile":6952.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":11787.77,"10th_percentile":11787.77,"90th_percentile":12389.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6528.92,"10th_percentile":6528.92,"90th_percentile":6528.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System Diagnoses Without Cc/Mcc","code_information":[{"code":"395","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3897.86,"maximum":9458.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9458.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4872.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5910.78},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7242.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4872.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8615.48},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4872.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4969.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4872.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4872.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3897.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4872.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4872.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4872.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8939.53},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4872.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2626.76,"10th_percentile":2626.76,"90th_percentile":2626.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4843.16,"10th_percentile":4843.16,"90th_percentile":4843.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5854.07,"10th_percentile":5854.07,"90th_percentile":5854.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2283.34,"10th_percentile":2283.34,"90th_percentile":2283.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":9686.33,"10th_percentile":9686.33,"90th_percentile":9686.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Appendix Procedures With Mcc","code_information":[{"code":"397","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14383.67,"maximum":35334.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35334.22},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17979.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22081.8},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27057.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17979.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32186.15},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17979.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18339.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17979.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17979.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14383.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17979.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17979.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17979.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33396.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17979.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17803.33,"10th_percentile":17803.33,"90th_percentile":17803.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":26098.67,"10th_percentile":26098.67,"90th_percentile":26098.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":34590.43,"10th_percentile":34590.43,"90th_percentile":34590.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Appendix Procedures With Cc","code_information":[{"code":"398","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9090.62,"maximum":22565.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22565.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11363.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14101.93},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17279.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11363.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20554.78},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11363.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11590.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11363.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11363.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9090.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11363.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11363.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11363.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21327.91},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11363.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8486.87,"10th_percentile":8486.87,"90th_percentile":8486.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28532.87,"10th_percentile":28532.87,"90th_percentile":34887.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9766.79,"10th_percentile":9766.79,"90th_percentile":9766.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":19413.28,"10th_percentile":19413.28,"90th_percentile":19413.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":21211.59,"10th_percentile":21211.59,"90th_percentile":21211.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":140.0,"10th_percentile":140.0,"90th_percentile":140.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Appendix Procedures Without Cc/Mcc","code_information":[{"code":"399","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6875.02,"maximum":17838.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17838.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8593.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11147.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13660.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8593.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16249.07},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8593.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8765.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8593.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8593.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6875.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8593.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8593.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8593.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16860.24},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8593.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12917.99,"10th_percentile":10499.82,"90th_percentile":21578.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":441.79,"10th_percentile":441.79,"90th_percentile":9615.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8505.68,"10th_percentile":8505.68,"90th_percentile":8505.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":254.8,"10th_percentile":254.8,"90th_percentile":15727.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Knee Procedures With Principal Diagnosis Of Infection","code_information":[{"code":"400","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18762.72,"maximum":30023.19,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30023.19},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18762.72},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22990.71},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27348.3},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28376.95}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical","code_information":[{"code":"402","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24146.96,"maximum":60718.05,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60718.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30183.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37945.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46495.77},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30183.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55308.42},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30183.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30787.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30183.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30183.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24146.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30183.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30183.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30183.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57388.73},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30183.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":29839.83,"10th_percentile":29839.83,"90th_percentile":29839.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":64454.94,"10th_percentile":40589.08,"90th_percentile":72920.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":62893.99,"10th_percentile":62893.99,"90th_percentile":62893.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":29824.23,"10th_percentile":29824.23,"90th_percentile":29824.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":29253.73,"10th_percentile":29246.01,"90th_percentile":29256.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip Or Knee Procedures With Principal Diagnosis Of Periprosthetic Joint Infection With Mcc Or Insert","code_information":[{"code":"403","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":46376.33,"maximum":74209.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74209.14},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":46376.33},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56826.77},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67597.53},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70140.07}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip Or Knee Procedures With Principal Diagnosis Of Periprosthetic Joint Infection Without Mcc","code_information":[{"code":"404","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30133.96,"maximum":48218.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48218.89},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30133.96},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36924.34},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43922.86},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45574.93}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pancreas, Liver And Shunt Procedures With Mcc","code_information":[{"code":"405","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32855.6,"maximum":79792.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79792.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41069.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":49865.91},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61102.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41069.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72683.89},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41069.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41890.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41069.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41069.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32855.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41069.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41069.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41069.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":75417.74},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41069.5,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":66338.9,"10th_percentile":66338.9,"90th_percentile":66338.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23765.98,"10th_percentile":23765.98,"90th_percentile":23765.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24172.48,"10th_percentile":1350.0,"90th_percentile":64272.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24184.24,"10th_percentile":24184.24,"90th_percentile":24184.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pancreas, Liver And Shunt Procedures With Cc","code_information":[{"code":"406","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17418.48,"maximum":43710.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43710.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21773.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27316.17},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33471.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21773.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39815.69},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21773.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22208.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21773.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21773.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17418.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21773.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21773.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21773.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41313.27},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21773.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16457.8,"10th_percentile":16457.8,"90th_percentile":16457.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":73067.34,"10th_percentile":73067.34,"90th_percentile":73067.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":37485.09,"10th_percentile":37485.09,"90th_percentile":37485.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":17959.92,"10th_percentile":17959.92,"90th_percentile":17959.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21087.38,"10th_percentile":17968.92,"90th_percentile":21100.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pancreas, Liver And Shunt Procedures Without Cc/Mcc","code_information":[{"code":"407","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13330.82,"maximum":32174.59,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32174.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16663.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20107.22},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24638.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16663.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29308.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16663.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16996.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16663.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16663.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13330.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16663.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16663.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16663.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30410.38},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16663.53,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15444.99,"10th_percentile":15444.99,"90th_percentile":15444.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15044.42,"10th_percentile":15044.42,"90th_percentile":15044.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1749.59,"10th_percentile":1749.59,"90th_percentile":1749.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16133.58,"10th_percentile":15148.66,"90th_percentile":16155.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. With Mcc","code_information":[{"code":"408","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21414.85,"maximum":49255.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49255.29},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26768.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30781.65},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37717.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26768.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44866.93},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26768.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27303.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26768.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26768.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21414.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26768.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26768.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26768.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46554.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26768.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. With Cc","code_information":[{"code":"409","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13076.78,"maximum":33095.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33095.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16345.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20682.64},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25343.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16345.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30146.74},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16345.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16672.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16345.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16345.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13076.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16345.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16345.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16345.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31280.65},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16345.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11772.08,"10th_percentile":11772.08,"90th_percentile":11772.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16145.04,"10th_percentile":16145.04,"90th_percentile":16145.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. Without Cc/Mcc","code_information":[{"code":"410","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9535.66,"maximum":26177.07,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26177.07},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11919.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16359.12},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20045.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11919.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23844.84},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11919.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12157.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11919.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11919.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9535.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11919.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11919.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11919.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24741.72},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11919.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Digestive Malignancy With Cc","code_information":[{"code":"375","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7264.81,"maximum":17552.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17552.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9081.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10969.09},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13440.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9081.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15988.4},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9081.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9262.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9081.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9081.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7264.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9081.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9081.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9081.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16589.77},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9081.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8968.05,"10th_percentile":8968.05,"90th_percentile":8968.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17236.8,"10th_percentile":17236.8,"90th_percentile":17236.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8996.05,"10th_percentile":8996.05,"90th_percentile":8996.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8793.04,"10th_percentile":8793.04,"90th_percentile":8793.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Digestive Malignancy With Mcc","code_information":[{"code":"374","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12844.94,"maximum":31286.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31286.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16056.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19552.19},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23958.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16056.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28499.01},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16056.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16377.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16056.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16056.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12844.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16056.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16056.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16056.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29570.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16056.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":40316.63,"10th_percentile":30476.48,"90th_percentile":40316.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14454.0,"10th_percentile":14454.0,"90th_percentile":14454.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12388.15,"10th_percentile":12388.15,"90th_percentile":15905.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15545.55,"10th_percentile":15545.55,"90th_percentile":15602.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc","code_information":[{"code":"373","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4368.74,"maximum":10297.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10297.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5460.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6435.24},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7885.35},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5460.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9379.92},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5460.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5570.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5460.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5460.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4368.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5460.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5460.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5460.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9732.72},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5460.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13712.22,"10th_percentile":13712.22,"90th_percentile":13712.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":1948.0,"10th_percentile":1948.0,"90th_percentile":8461.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2121.63,"10th_percentile":2121.63,"90th_percentile":2121.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":10323.99,"10th_percentile":10323.99,"90th_percentile":10856.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5335.74,"10th_percentile":5335.74,"90th_percentile":5335.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Gastrointestinal Disorders And Peritoneal Infections With Cc","code_information":[{"code":"372","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6132.08,"maximum":14775.11,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14775.11},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7665.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9233.57},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11314.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7665.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13458.73},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7665.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7818.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7665.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7665.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6132.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7665.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7665.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7665.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13964.95},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7665.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":5424.58,"10th_percentile":5424.58,"90th_percentile":5424.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7569.76,"10th_percentile":7569.76,"90th_percentile":7569.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":49332.19,"10th_percentile":49332.19,"90th_percentile":49332.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5851.62,"10th_percentile":5851.62,"90th_percentile":5851.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7572.86,"10th_percentile":7571.76,"90th_percentile":7605.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":13606.87,"10th_percentile":13606.87,"90th_percentile":13606.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Gastrointestinal Disorders And Peritoneal Infections With Mcc","code_information":[{"code":"371","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10649.17,"maximum":25334.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25334.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13311.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15832.81},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19400.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13311.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23077.7},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13311.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13577.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13311.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13311.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10649.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13311.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13311.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13311.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23945.72},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13311.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":29489.18,"10th_percentile":29489.18,"90th_percentile":29489.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6308.47,"10th_percentile":6308.47,"90th_percentile":6308.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21827.11,"10th_percentile":21827.11,"90th_percentile":21827.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13152.17,"10th_percentile":13152.17,"90th_percentile":13196.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10126.48,"10th_percentile":10126.48,"90th_percentile":10126.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12930.1,"10th_percentile":9913.53,"90th_percentile":12932.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Esophageal Disorders Without Cc/Mcc","code_information":[{"code":"370","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4208.98,"maximum":9994.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9994.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5261.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6246.21},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7653.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5261.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9104.39},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5261.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5366.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5261.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5261.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4208.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5261.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5261.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5261.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9446.84},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5261.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":250.0,"10th_percentile":250.0,"90th_percentile":250.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Esophageal Disorders With Cc","code_information":[{"code":"369","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6007.16,"maximum":14709.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14709.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7508.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9192.8},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11264.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7508.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13399.3},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7508.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7659.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7508.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7508.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6007.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7508.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7508.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7508.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13903.29},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7508.95,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":14123.82,"10th_percentile":14123.82,"90th_percentile":14123.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7447.84,"10th_percentile":7447.84,"90th_percentile":7447.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":10535.11,"10th_percentile":10535.11,"90th_percentile":10535.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":227.76,"10th_percentile":227.76,"90th_percentile":227.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Esophageal Disorders With Mcc","code_information":[{"code":"368","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9560.89,"maximum":24366.69,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24366.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11951.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15227.74},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18659.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11951.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22195.76},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11951.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12190.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11951.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11951.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9560.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11951.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11951.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11951.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23030.61},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11951.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21343.51,"10th_percentile":21343.51,"90th_percentile":21343.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":19524.21,"10th_percentile":19524.21,"90th_percentile":19524.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Circulatory System O.R. Procedures Without Mcc","code_information":[{"code":"362","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20354.62,"maximum":32570.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32570.47},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20354.62},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24941.33},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29668.63},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30784.55}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Circulatory System O.R. Procedures With Mcc","code_information":[{"code":"361","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":34822.55,"maximum":55721.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55721.35},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34822.55},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42669.47},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50756.9},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52666.01}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc","code_information":[{"code":"360","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14500.18,"maximum":34693.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34693.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18125.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21681.51},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26567.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18125.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31602.69},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18125.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18487.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18125.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18125.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14500.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18125.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18125.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18125.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32791.36},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18125.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":33834.0,"10th_percentile":33834.0,"90th_percentile":33834.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc","code_information":[{"code":"359","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20652.09,"maximum":50093.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50093.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25815.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31305.18},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38359.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25815.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45630.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25815.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26331.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25815.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25815.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20652.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25815.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25815.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25815.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47346.3},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25815.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":46596.31,"10th_percentile":46596.31,"90th_percentile":46596.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25513.89,"10th_percentile":25513.89,"90th_percentile":25513.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System O.R. Procedures Without Cc/Mcc","code_information":[{"code":"358","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8395.73,"maximum":22068.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22068.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10494.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13791.51},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16899.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10494.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20102.33},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10494.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10704.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10494.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10494.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8395.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10494.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10494.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10494.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20858.44},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10494.66,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8059.16,"10th_percentile":8059.16,"90th_percentile":8059.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System O.R. Procedures With Cc","code_information":[{"code":"357","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13966.86,"maximum":33872.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33872.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17458.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21168.18},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25938.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17458.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30854.46},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17458.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17807.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17458.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17458.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13966.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17458.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17458.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17458.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32014.98},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17458.57,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16628.92,"10th_percentile":16628.92,"90th_percentile":16628.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Digestive System O.R. Procedures With Mcc","code_information":[{"code":"356","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":26382.98,"maximum":64319.53,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64319.53},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32978.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40195.91},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49253.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32978.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58589.03},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32978.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33638.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32978.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32978.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26382.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32978.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32978.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32978.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60792.73},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32978.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":82808.67,"10th_percentile":82808.67,"90th_percentile":82808.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":29413.41,"10th_percentile":29413.41,"90th_percentile":29413.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc","code_information":[{"code":"355","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8078.02,"maximum":20611.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20611.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10097.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12880.67},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15783.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10097.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18774.69},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10097.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10299.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10097.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10097.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8078.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10097.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10097.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10097.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19480.86},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10097.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":395.0,"10th_percentile":395.0,"90th_percentile":395.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15605.72,"10th_percentile":15605.72,"90th_percentile":15605.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8276.3,"10th_percentile":8276.3,"90th_percentile":8276.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":8078.02,"10th_percentile":8078.02,"90th_percentile":8078.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":20074.13,"10th_percentile":20074.13,"90th_percentile":20074.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9777.32,"10th_percentile":9777.32,"90th_percentile":9777.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hernia Procedures Except Inguinal And Femoral With Cc","code_information":[{"code":"354","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10104.42,"maximum":25484.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25484.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12630.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15926.4},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19515.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12630.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23214.11},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12630.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12883.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12630.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12630.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10104.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12630.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12630.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12630.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24087.26},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12630.53,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":82943.2,"10th_percentile":82943.2,"90th_percentile":82943.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12479.6,"10th_percentile":12479.6,"90th_percentile":12479.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":115.0,"10th_percentile":115.0,"90th_percentile":115.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hernia Procedures Except Inguinal And Femoral With Mcc","code_information":[{"code":"353","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17429.3,"maximum":40820.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40820.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21786.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25510.22},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31258.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21786.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37183.37},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21786.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22222.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21786.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21786.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17429.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21786.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21786.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21786.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38581.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21786.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21519.74,"10th_percentile":21519.74,"90th_percentile":21519.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21116.24,"10th_percentile":21116.24,"90th_percentile":21116.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inguinal And Femoral Hernia Procedures Without Cc/Mcc","code_information":[{"code":"352","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7013.76,"maximum":18115.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18115.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8767.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11321.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13872.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8767.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16501.63},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8767.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8942.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8767.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8767.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7013.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8767.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8767.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8767.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17122.31},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8767.2,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25.0,"10th_percentile":25.0,"90th_percentile":25.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inguinal And Femoral Hernia Procedures With Cc","code_information":[{"code":"351","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9156.09,"maximum":23184.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23184.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11445.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14489.24},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17754.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11445.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21119.33},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11445.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11674.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11445.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11445.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9156.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11445.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11445.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11445.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21913.69},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11445.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11308.54,"10th_percentile":11308.54,"90th_percentile":11308.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28738.35,"10th_percentile":28738.35,"90th_percentile":28738.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11323.79,"10th_percentile":11323.79,"90th_percentile":11323.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":140.0,"10th_percentile":140.0,"90th_percentile":140.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inguinal And Femoral Hernia Procedures With Mcc","code_information":[{"code":"350","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14966.25,"maximum":38207.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38207.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18707.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23877.56},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29258.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18707.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34803.61},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18707.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19081.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18707.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18707.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14966.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18707.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18707.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18707.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36112.68},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18707.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Anal And Stomal Procedures Without Cc/Mcc","code_information":[{"code":"349","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5228.78,"maximum":13537.05,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13537.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6535.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8459.86},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10366.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6535.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12330.98},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6535.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6666.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6535.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6535.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5228.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6535.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6535.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6535.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12794.78},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6535.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8382.48,"10th_percentile":8382.48,"90th_percentile":8382.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Anal And Stomal Procedures With Cc","code_information":[{"code":"348","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7860.6,"maximum":17681.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17681.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9825.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11049.71},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13539.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9825.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16105.91},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9825.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10022.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9825.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9825.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7860.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9825.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9825.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9825.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16711.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9825.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1650.0,"10th_percentile":1650.0,"90th_percentile":1650.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Anal And Stomal Procedures With Mcc","code_information":[{"code":"347","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13787.28,"maximum":34966.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34966.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17234.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21852.01},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26776.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17234.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31851.2},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17234.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17578.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17234.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17234.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13787.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17234.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17234.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17234.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33049.22},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17234.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Small And Large Bowel Procedures Without Cc/Mcc","code_information":[{"code":"346","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7124.27,"maximum":18782.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18782.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8905.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11738.17},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14383.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8905.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17109.4},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8905.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9083.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8905.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8905.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7124.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8905.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8905.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8905.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17752.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8905.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":12374.55,"10th_percentile":12374.55,"90th_percentile":12374.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Small And Large Bowel Procedures With Cc","code_information":[{"code":"345","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9037.17,"maximum":22155.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22155.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11296.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13846.18},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16966.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11296.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20182.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11296.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11522.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11296.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11296.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9037.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11296.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11296.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11296.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20941.12},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11296.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11155.94,"10th_percentile":11155.94,"90th_percentile":11155.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20095.82,"10th_percentile":20095.82,"90th_percentile":20095.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11184.99,"10th_percentile":11184.99,"90th_percentile":11184.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":17704.04,"10th_percentile":17704.04,"90th_percentile":17704.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10.0,"10th_percentile":10.0,"90th_percentile":10.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Small And Large Bowel Procedures With Mcc","code_information":[{"code":"344","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15512.19,"maximum":41819.55,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41819.55},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19390.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26134.75},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32023.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19390.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38093.67},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19390.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19778.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19390.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19390.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15512.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19390.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19390.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19390.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39526.49},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19390.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peritoneal Adhesiolysis Without Cc/Mcc","code_information":[{"code":"337","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9219.14,"maximum":22603.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22603.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14126.02},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17309.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20589.9},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11754.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9219.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11523.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21364.34},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11409.58,"10th_percentile":11409.58,"90th_percentile":11409.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21273.75,"10th_percentile":21273.75,"90th_percentile":21273.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11383.65,"10th_percentile":11383.65,"90th_percentile":11383.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":21511.49,"10th_percentile":21511.49,"90th_percentile":21511.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11162.79,"10th_percentile":11162.79,"90th_percentile":11162.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peritoneal Adhesiolysis With Cc","code_information":[{"code":"336","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12664.77,"maximum":31167.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31167.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15830.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19478.06},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23867.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15830.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28390.96},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15830.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16147.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15830.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15830.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12664.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15830.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15830.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15830.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29458.83},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15830.96,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":102208.91,"10th_percentile":102208.91,"90th_percentile":102208.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15635.52,"10th_percentile":15635.52,"90th_percentile":15635.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19277.76,"10th_percentile":19277.76,"90th_percentile":19277.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":22603.24,"10th_percentile":22603.24,"90th_percentile":22603.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15359.6,"10th_percentile":15359.6,"90th_percentile":15359.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15328.94,"10th_percentile":15328.94,"90th_percentile":15328.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peritoneal Adhesiolysis With Mcc","code_information":[{"code":"335","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21446.68,"maximum":51940.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51940.46},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26808.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32459.72},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39774.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26808.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47312.87},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26808.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27344.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26808.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26808.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21446.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26808.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26808.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26808.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49092.44},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26808.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11391.65,"10th_percentile":11391.65,"90th_percentile":11391.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":120.0,"10th_percentile":120.0,"90th_percentile":26477.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Rectal Resection Without Cc/Mcc","code_information":[{"code":"334","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9837.16,"maximum":24970.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24970.15},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12296.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15604.87},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19121.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12296.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22745.45},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12296.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12542.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12296.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12296.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9837.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12296.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12296.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12296.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23600.98},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12296.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Rectal Resection With Cc","code_information":[{"code":"333","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14067.16,"maximum":31553.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31553.34},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17583.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19718.97},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24162.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17583.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28742.12},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17583.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17935.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17583.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17583.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14067.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17583.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17583.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17583.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29823.19},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17583.95,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17028.33,"10th_percentile":17028.33,"90th_percentile":17028.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Rectal Resection With Mcc","code_information":[{"code":"332","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21745.78,"maximum":56149.85,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56149.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27182.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35090.34},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42997.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27182.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51147.22},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27182.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27725.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27182.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27182.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21745.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27182.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27182.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27182.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53071.02},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27182.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Small And Large Bowel Procedures Without Cc/Mcc","code_information":[{"code":"331","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10107.42,"maximum":25899.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25899.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12634.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16185.85},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19833.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12634.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23592.28},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12634.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12886.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12634.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12634.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10107.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12634.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12634.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12634.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24479.66},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12634.28,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12485.62,"10th_percentile":12485.62,"90th_percentile":12485.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23981.33,"10th_percentile":20167.98,"90th_percentile":28466.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11897.41,"10th_percentile":11897.41,"90th_percentile":11897.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":17725.99,"10th_percentile":17725.99,"90th_percentile":21351.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12490.3,"10th_percentile":9247.68,"90th_percentile":12512.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":23584.16,"10th_percentile":23584.16,"90th_percentile":23584.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12254.48,"10th_percentile":12243.63,"90th_percentile":12255.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Small And Large Bowel Procedures With Cc","code_information":[{"code":"330","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14397.49,"maximum":35970.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35970.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17996.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22479.32},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27544.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17996.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32765.56},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17996.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18356.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17996.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17996.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14397.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17996.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17996.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17996.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33997.96},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17996.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":29205.88,"10th_percentile":29205.88,"90th_percentile":29205.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17085.82,"10th_percentile":11119.16,"90th_percentile":21771.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":34160.1,"10th_percentile":23070.95,"90th_percentile":45189.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17497.26,"10th_percentile":17497.26,"90th_percentile":17497.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":30983.81,"10th_percentile":25249.71,"90th_percentile":30983.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17790.49,"10th_percentile":17774.65,"90th_percentile":17810.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17439.5,"10th_percentile":14519.83,"90th_percentile":17461.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Small And Large Bowel Procedures With Mcc","code_information":[{"code":"329","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27606.39,"maximum":67424.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67424.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34507.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42136.21},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51631.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34507.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61417.18},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34507.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35198.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34507.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34507.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27606.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34507.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34507.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34507.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63727.26},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34507.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":34078.75,"10th_percentile":17785.59,"90th_percentile":34126.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":54515.54,"10th_percentile":46275.2,"90th_percentile":85101.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19836.64,"10th_percentile":19836.64,"90th_percentile":19836.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":48414.93,"10th_percentile":48414.93,"90th_percentile":89543.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":34081.95,"10th_percentile":19641.44,"90th_percentile":70877.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32042.24,"10th_percentile":32042.24,"90th_percentile":39624.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc","code_information":[{"code":"328","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9623.34,"maximum":24415.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24415.62},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12029.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15258.32},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18696.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12029.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22240.33},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12029.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12269.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12029.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12029.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9623.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12029.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12029.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12029.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23076.85},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12029.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17719.82,"10th_percentile":17719.82,"90th_percentile":17719.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11892.68,"10th_percentile":11892.68,"90th_percentile":11920.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Stomach, Esophageal And Duodenal Procedures With Cc","code_information":[{"code":"327","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14679.77,"maximum":36297.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36297.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18349.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22684.09},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27795.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18349.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33064.04},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18349.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18716.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18349.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18349.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14679.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18349.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18349.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18349.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34307.67},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18349.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":69203.22,"10th_percentile":69203.22,"90th_percentile":74115.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18121.45,"10th_percentile":18121.45,"90th_percentile":18121.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17766.14,"10th_percentile":17766.14,"90th_percentile":17766.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Stomach, Esophageal And Duodenal Procedures With Mcc","code_information":[{"code":"326","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":29954.12,"maximum":73297.27,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73297.27},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37442.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45806.47},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56128.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37442.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66766.91},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37442.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38191.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37442.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37442.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29954.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37442.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37442.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37442.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69278.21},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37442.65,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33289.06,"10th_percentile":33289.06,"90th_percentile":33289.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":99139.31,"10th_percentile":99139.31,"90th_percentile":99139.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":74368.11,"10th_percentile":74368.11,"90th_percentile":74368.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":63920.52,"10th_percentile":63920.52,"90th_percentile":63920.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":36274.49,"10th_percentile":36274.49,"90th_percentile":36274.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Intravascular Lithotripsy Without Intraluminal Device","code_information":[{"code":"325","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19281.53,"maximum":49453.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49453.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24101.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30905.82},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37870.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24101.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45047.91},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24101.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24583.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24101.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24101.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19281.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24101.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24101.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24101.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46742.3},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24101.91,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc","code_information":[{"code":"324","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18924.78,"maximum":47311.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47311.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23655.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29566.88},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36229.48},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23655.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43096.3},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23655.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24129.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23655.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23655.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18924.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23655.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23655.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23655.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44717.27},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23655.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2710.89,"10th_percentile":2710.89,"90th_percentile":2710.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22612.12,"10th_percentile":22612.12,"90th_percentile":22612.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":35484.51,"10th_percentile":35484.51,"90th_percentile":35484.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23365.72,"10th_percentile":23365.72,"90th_percentile":23365.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22903.64,"10th_percentile":22903.64,"90th_percentile":22918.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc","code_information":[{"code":"323","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25990.18,"maximum":65763.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65763.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32487.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41098.42},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50359.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32487.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59904.51},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32487.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33137.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32487.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32487.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25990.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32487.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32487.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32487.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62157.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32487.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32131.03,"10th_percentile":32131.03,"90th_percentile":32131.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32100.23,"10th_percentile":32095.63,"90th_percentile":32104.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc","code_information":[{"code":"322","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10588.5,"maximum":26314.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26314.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13235.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16445.3},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20151.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13235.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23970.45},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13235.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13500.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13235.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13235.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10588.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13235.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13235.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13235.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24872.05},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13235.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":26140.0,"10th_percentile":26140.0,"90th_percentile":26140.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13086.79,"10th_percentile":13072.22,"90th_percentile":13094.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"13","median_amount":25781.1,"10th_percentile":22538.54,"90th_percentile":33234.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12643.21,"10th_percentile":12643.21,"90th_percentile":12643.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":22786.78,"10th_percentile":22786.78,"90th_percentile":22786.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13089.91,"10th_percentile":13076.21,"90th_percentile":13102.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12825.7,"10th_percentile":12819.81,"90th_percentile":12843.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ Arteries/Intraluminal","code_information":[{"code":"321","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16341.02,"maximum":40250.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40250.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20426.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25154.41},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30822.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20426.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36664.74},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20426.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20834.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20426.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20426.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16341.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20426.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20426.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20426.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38043.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20426.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":45302.55,"10th_percentile":45302.55,"90th_percentile":45302.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20172.16,"10th_percentile":20172.16,"90th_percentile":20172.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":36971.4,"10th_percentile":22228.3,"90th_percentile":51289.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19859.23,"10th_percentile":19859.23,"90th_percentile":19859.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":35047.51,"10th_percentile":35047.51,"90th_percentile":35047.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20172.56,"10th_percentile":13094.99,"90th_percentile":20185.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":40607.94,"10th_percentile":40607.94,"90th_percentile":40607.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19821.0,"10th_percentile":19821.0,"90th_percentile":19821.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Endovascular Cardiac Valve Procedures Without Mcc","code_information":[{"code":"320","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14446.14,"maximum":32097.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32097.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18057.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20059.04},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24579.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18057.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29237.79},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18057.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18418.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18057.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18057.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14446.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18057.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18057.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18057.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30337.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18057.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Endovascular Cardiac Valve Procedures With Mcc","code_information":[{"code":"319","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":26803.99,"maximum":63257.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63257.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33504.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39532.46},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48440.71},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33504.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57622.0},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33504.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34175.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33504.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33504.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26803.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33504.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33504.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33504.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59789.33},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33504.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Coronary Atherectomy Without Intraluminal Device","code_information":[{"code":"318","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14547.63,"maximum":38823.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38823.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18184.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24262.09},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29729.31},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18184.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35364.11},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18184.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18548.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18184.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18184.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14547.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18184.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18184.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18184.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36694.26},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18184.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Concomitant Left Atrial Appendage Closure And Cardiac Ablation","code_information":[{"code":"317","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":40158.84,"maximum":105108.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":105108.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50198.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":65686.67},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":80488.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50198.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":95744.03},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50198.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51202.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50198.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50198.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40158.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":50198.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50198.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50198.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":99345.25},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50198.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":49618.29,"10th_percentile":49618.29,"90th_percentile":49618.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":48415.46,"10th_percentile":48415.46,"90th_percentile":48415.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":49581.12,"10th_percentile":49574.52,"90th_percentile":55886.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":48606.09,"10th_percentile":48606.09,"90th_percentile":48606.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Circulatory System Diagnoses Without Cc/Mcc","code_information":[{"code":"316","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4096.66,"maximum":9901.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9901.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5120.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6187.83},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7582.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5120.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9019.31},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5120.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5223.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5120.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5120.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4096.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5120.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5120.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5120.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9358.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5120.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":3362.32,"10th_percentile":3362.32,"90th_percentile":3362.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Circulatory System Diagnoses With Cc","code_information":[{"code":"315","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5785.54,"maximum":14101.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14101.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8812.89},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10798.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12845.56},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7376.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5785.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13328.72},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7231.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7144.07,"10th_percentile":7144.07,"90th_percentile":7144.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9994.24,"10th_percentile":5145.8,"90th_percentile":17659.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5182.87,"10th_percentile":5182.87,"90th_percentile":5182.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":8117.15,"10th_percentile":8117.15,"90th_percentile":8117.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7153.96,"10th_percentile":552.35,"90th_percentile":7161.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":280.99,"10th_percentile":280.99,"90th_percentile":280.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Circulatory System Diagnoses With Mcc","code_information":[{"code":"314","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12523.62,"maximum":30945.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30945.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15654.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19339.07},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23696.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15654.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28188.37},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15654.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15967.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15654.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15654.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12523.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15654.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15654.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15654.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29248.62},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15654.53,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19371.18,"10th_percentile":19371.18,"90th_percentile":19371.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21633.95,"10th_percentile":21633.95,"90th_percentile":21633.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15218.53,"10th_percentile":15218.53,"90th_percentile":15218.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":24855.77,"10th_percentile":24855.77,"90th_percentile":24855.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15459.8,"10th_percentile":3814.37,"90th_percentile":73194.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":1274.0,"10th_percentile":1274.0,"90th_percentile":1274.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15161.68,"10th_percentile":15161.68,"90th_percentile":15177.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chest Pain","code_information":[{"code":"313","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4324.29,"maximum":10546.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10546.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5405.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6590.91},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8076.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5405.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9606.82},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5405.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5513.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5405.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5405.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4324.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5405.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5405.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5405.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9968.16},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5405.36,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5340.27,"10th_percentile":5340.27,"90th_percentile":5340.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9260.0,"10th_percentile":6895.2,"90th_percentile":18175.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":1948.0,"10th_percentile":1948.0,"90th_percentile":1948.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3344.15,"10th_percentile":3344.15,"90th_percentile":3344.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5347.39,"10th_percentile":5347.39,"90th_percentile":6563.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":565.74,"10th_percentile":565.74,"90th_percentile":5934.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":1274.0,"10th_percentile":1274.0,"90th_percentile":1274.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":550.0,"10th_percentile":273.09,"90th_percentile":5244.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Syncope And Collapse","code_information":[{"code":"312","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5234.79,"maximum":12838.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12838.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6543.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8023.43},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9831.43},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6543.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11694.85},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6543.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6674.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6543.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6543.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5234.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6543.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6543.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6543.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12134.72},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6543.49,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6462.09,"10th_percentile":6462.09,"90th_percentile":6463.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16389.84,"10th_percentile":16389.84,"90th_percentile":16389.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6361.25,"10th_percentile":6361.25,"90th_percentile":6361.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6464.09,"10th_percentile":71.63,"90th_percentile":6474.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":922.38,"10th_percentile":922.38,"90th_percentile":922.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":12214.6,"10th_percentile":12214.6,"90th_percentile":12214.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":130.0,"10th_percentile":130.0,"90th_percentile":6379.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Angina Pectoris","code_information":[{"code":"311","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4215.58,"maximum":9905.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9905.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5269.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6190.61},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7585.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5269.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9023.36},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5269.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5374.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5269.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5269.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4215.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5269.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5269.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5269.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9362.75},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5269.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":790.07,"10th_percentile":790.07,"90th_percentile":790.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc","code_information":[{"code":"310","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3399.98,"maximum":8430.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8430.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5268.65},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6455.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7679.51},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4334.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3399.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4249.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7968.36},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":8393.56,"10th_percentile":8393.56,"90th_percentile":8393.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":4197.49,"10th_percentile":1958.0,"90th_percentile":4221.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8066.93,"10th_percentile":5833.27,"90th_percentile":19547.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3913.78,"10th_percentile":3913.78,"90th_percentile":4056.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":5053.47,"10th_percentile":2792.0,"90th_percentile":5962.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4218.49,"10th_percentile":1763.12,"90th_percentile":14899.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":753.57,"10th_percentile":61.53,"90th_percentile":27156.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":1307.0,"10th_percentile":1307.0,"90th_percentile":1307.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4115.01,"10th_percentile":130.0,"90th_percentile":4125.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Arrhythmia And Conduction Disorders With Cc","code_information":[{"code":"309","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4418.58,"maximum":10851.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10851.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6781.79},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8309.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9885.04},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5633.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4418.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5523.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10256.85},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5523.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4204.68,"10th_percentile":2856.52,"90th_percentile":5458.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9483.73,"10th_percentile":5428.84,"90th_percentile":13860.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5054.63,"10th_percentile":5054.63,"90th_percentile":5054.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5455.31,"10th_percentile":102.8,"90th_percentile":5469.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":707.44,"10th_percentile":304.59,"90th_percentile":3173.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":10980.32,"10th_percentile":10980.32,"90th_percentile":10980.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5350.07,"10th_percentile":5348.08,"90th_percentile":5392.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Arrhythmia And Conduction Disorders With Mcc","code_information":[{"code":"308","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7231.18,"maximum":17509.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17509.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10942.22},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13407.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15949.24},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9219.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7231.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16549.13},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8930.53,"10th_percentile":4197.49,"90th_percentile":8973.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16797.26,"10th_percentile":16797.26,"90th_percentile":16797.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8403.04,"10th_percentile":8403.04,"90th_percentile":8403.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8928.93,"10th_percentile":567.59,"90th_percentile":13869.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":8792.4,"10th_percentile":8792.4,"90th_percentile":8792.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8751.5,"10th_percentile":150.0,"90th_percentile":8800.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Congenital And Valvular Disorders Without Mcc","code_information":[{"code":"307","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5484.64,"maximum":13560.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13560.77},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6855.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8474.68},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10384.37},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6855.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12352.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6855.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6992.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6855.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6855.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5484.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6855.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6855.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6855.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12817.2},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6855.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Congenital And Valvular Disorders With Mcc","code_information":[{"code":"306","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9464.19,"maximum":22918.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22918.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11830.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14322.46},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17549.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11830.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20876.22},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11830.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12066.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11830.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11830.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9464.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11830.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11830.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11830.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21661.44},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11830.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15298.93,"10th_percentile":15298.93,"90th_percentile":15298.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11500.76,"10th_percentile":11500.76,"90th_percentile":11500.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11685.49,"10th_percentile":11685.49,"90th_percentile":11685.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hypertension Without Mcc","code_information":[{"code":"305","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4535.1,"maximum":11237.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11237.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7022.7},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8605.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10236.2},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5782.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4535.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5668.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10621.21},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":9275.65,"10th_percentile":9275.65,"90th_percentile":9275.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5604.88,"10th_percentile":5604.88,"90th_percentile":5604.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17686.13,"10th_percentile":10760.18,"90th_percentile":18757.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5435.98,"10th_percentile":5435.98,"90th_percentile":5435.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5604.88,"10th_percentile":5602.35,"90th_percentile":5617.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1182.73,"10th_percentile":1182.73,"90th_percentile":1182.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":10717.13,"10th_percentile":10717.13,"90th_percentile":10717.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5493.58,"10th_percentile":273.69,"90th_percentile":5510.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hypertension With Mcc","code_information":[{"code":"304","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7147.09,"maximum":17807.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17807.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8933.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11128.47},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13636.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8933.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16220.71},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8933.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9112.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8933.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8933.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7147.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8933.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8933.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8933.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16830.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8933.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":1066.28,"10th_percentile":1066.28,"90th_percentile":1066.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12346.25,"10th_percentile":12346.25,"90th_percentile":12346.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8823.56,"10th_percentile":8823.56,"90th_percentile":8834.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3905.46,"10th_percentile":3905.46,"90th_percentile":3905.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Atherosclerosis Without Mcc","code_information":[{"code":"303","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4043.21,"maximum":9800.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9800.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5054.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6124.83},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7504.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5054.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8927.47},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5054.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5155.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5054.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5054.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4043.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5054.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5054.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5054.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9263.25},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5054.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12690.49,"10th_percentile":12690.49,"90th_percentile":12690.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11963.1,"10th_percentile":11963.1,"90th_percentile":11963.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Atherosclerosis With Mcc","code_information":[{"code":"302","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7186.73,"maximum":17782.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17782.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8983.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11112.71},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13616.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8983.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16197.75},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8983.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9163.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8983.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8983.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7186.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8983.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8983.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8983.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16806.99},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8983.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peripheral Vascular Disorders Without Cc/Mcc","code_information":[{"code":"301","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4322.49,"maximum":10574.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10574.62},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5403.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6608.51},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8097.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5403.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9632.48},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5403.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5511.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5403.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5403.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4322.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5403.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5403.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5403.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9994.78},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5403.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":36311.21,"10th_percentile":36311.21,"90th_percentile":36311.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10255.73,"10th_percentile":10255.73,"90th_percentile":10255.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":9302.12,"10th_percentile":9302.12,"90th_percentile":9302.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5339.89,"10th_percentile":5336.8,"90th_percentile":5342.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peripheral Vascular Disorders With Cc","code_information":[{"code":"300","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6411.36,"maximum":15514.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15514.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8014.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9695.94},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11880.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8014.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14132.68},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8014.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8174.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8014.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8014.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6411.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8014.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8014.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8014.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14664.25},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8014.2,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7331.86,"10th_percentile":7331.86,"90th_percentile":7914.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7442.71,"10th_percentile":7442.71,"90th_percentile":7442.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7715.99,"10th_percentile":7715.99,"90th_percentile":7715.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7916.05,"10th_percentile":7669.67,"90th_percentile":7930.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":488.01,"10th_percentile":488.01,"90th_percentile":488.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":15932.44,"10th_percentile":15932.44,"90th_percentile":15932.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7815.06,"10th_percentile":7815.06,"90th_percentile":7815.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peripheral Vascular Disorders With Mcc","code_information":[{"code":"299","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9805.93,"maximum":23485.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23485.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12257.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14677.34},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17984.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12257.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21393.5},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12257.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12502.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12257.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12257.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9805.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12257.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12257.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12257.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22198.18},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12257.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12104.95,"10th_percentile":9311.12,"90th_percentile":12106.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9516.99,"10th_percentile":7971.92,"90th_percentile":16939.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":18373.23,"10th_percentile":18373.23,"90th_percentile":20352.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12146.95,"10th_percentile":12146.95,"90th_percentile":12146.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11889.8,"10th_percentile":11889.8,"90th_percentile":11889.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Arrest, Unexplained Without Cc/Mcc","code_information":[{"code":"298","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":2733.31,"maximum":7330.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7330.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3416.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4581.11},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5613.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3416.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6677.37},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3416.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3484.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3416.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3416.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":2733.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":3416.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3416.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3416.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6928.52},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3416.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Arrest, Unexplained With Mcc","code_information":[{"code":"296","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9380.7,"maximum":22231.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22231.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11725.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13893.44},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17024.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11725.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20250.9},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11725.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11960.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11725.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11725.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9380.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11725.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11725.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11725.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21012.59},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11725.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Heart Failure And Shock Without Cc/Mcc","code_information":[{"code":"293","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3399.38,"maximum":8095.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8095.54},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5059.24},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6199.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7374.28},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4334.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3399.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4249.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7651.64},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4249.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Heart Failure And Shock With Cc","code_information":[{"code":"292","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5099.06,"maximum":12770.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12770.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6373.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7980.81},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9779.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6373.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11632.72},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6373.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6501.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6373.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6373.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5099.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6373.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6373.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6373.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12070.26},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6373.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5426.32,"10th_percentile":5426.32,"90th_percentile":5426.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4341.74,"10th_percentile":4341.74,"90th_percentile":4341.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6220.21,"10th_percentile":6220.21,"90th_percentile":6220.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Heart Failure And Shock With Mcc","code_information":[{"code":"291","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7710.45,"maximum":18808.05,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18808.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9638.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11753.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14402.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9638.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17132.36},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9638.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9830.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9638.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9638.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7710.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9638.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9638.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9638.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17776.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9638.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":21009.65,"10th_percentile":21009.65,"90th_percentile":22461.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"23","median_amount":9518.18,"10th_percentile":5009.89,"90th_percentile":9541.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":14955.99,"10th_percentile":10784.43,"90th_percentile":60949.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":8214.64,"10th_percentile":6757.33,"90th_percentile":9369.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":30863.05,"10th_percentile":30863.05,"90th_percentile":30863.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"60","median_amount":9528.07,"10th_percentile":3598.5,"90th_percentile":9553.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":880.57,"10th_percentile":880.57,"90th_percentile":1043.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2706.82,"10th_percentile":2706.82,"90th_percentile":2706.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":17991.17,"10th_percentile":17991.17,"90th_percentile":17991.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"33","median_amount":9332.06,"10th_percentile":975.0,"90th_percentile":9365.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute And Subacute Endocarditis Without Cc/Mcc","code_information":[{"code":"290","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5583.74,"maximum":12405.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12405.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6979.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7752.86},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9499.89},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6979.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11300.47},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6979.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7119.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6979.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6979.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5583.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6979.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6979.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6979.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11725.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6979.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute And Subacute Endocarditis With Cc","code_information":[{"code":"289","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10251.57,"maximum":22777.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22777.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12814.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14234.43},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17442.01},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12814.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20747.92},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12814.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13070.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12814.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12814.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10251.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12814.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12814.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12814.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21528.31},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12814.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":17978.78,"10th_percentile":17978.78,"90th_percentile":17978.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5562.86,"10th_percentile":5562.86,"90th_percentile":5562.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute And Subacute Endocarditis With Mcc","code_information":[{"code":"288","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16253.33,"maximum":39000.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39000.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20316.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24373.29},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29865.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20316.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35526.18},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20316.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20722.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20316.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20316.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16253.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20316.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20316.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20316.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36862.43},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20316.66,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":51014.58,"10th_percentile":51014.58,"90th_percentile":51014.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc","code_information":[{"code":"287","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6426.98,"maximum":15992.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15992.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8033.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9994.31},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12246.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8033.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14567.57},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8033.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8194.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8033.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8033.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6426.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8033.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8033.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8033.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15115.5},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8033.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":15110.88,"10th_percentile":15110.88,"90th_percentile":15110.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7934.54,"10th_percentile":7934.54,"90th_percentile":7945.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11102.29,"10th_percentile":9402.29,"90th_percentile":20172.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":10289.0,"10th_percentile":10289.0,"90th_percentile":10289.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7939.79,"10th_percentile":7934.94,"90th_percentile":7979.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8401.49,"10th_percentile":8401.49,"90th_percentile":8401.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5082.7,"10th_percentile":5082.7,"90th_percentile":5082.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":20923.99,"10th_percentile":20923.99,"90th_percentile":20923.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7779.78,"10th_percentile":585.0,"90th_percentile":7800.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc","code_information":[{"code":"286","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13289.98,"maximum":32881.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32881.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16612.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20549.21},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25179.77},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16612.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29952.26},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16612.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16944.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16612.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16612.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13289.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16612.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16612.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16612.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31078.85},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16612.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":12978.61,"10th_percentile":12978.61,"90th_percentile":12978.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16429.55,"10th_percentile":16429.55,"90th_percentile":16429.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":31532.4,"10th_percentile":31532.4,"90th_percentile":41722.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14960.92,"10th_percentile":14960.92,"90th_percentile":14960.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16409.79,"10th_percentile":16408.25,"90th_percentile":16441.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16103.67,"10th_percentile":16096.69,"90th_percentile":16118.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Myocardial Infarction, Expired Without Cc/Mcc","code_information":[{"code":"285","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3596.97,"maximum":7991.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7991.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4496.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4994.37},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6119.81},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4496.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7279.73},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4496.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4586.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4496.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4496.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3596.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4496.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4496.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4496.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7553.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4496.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Myocardial Infarction, Expired With Cc","code_information":[{"code":"284","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4157.33,"maximum":11170.66,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11170.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5196.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6981.0},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8554.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5196.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10175.42},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5196.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5300.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5196.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5196.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4157.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5196.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5196.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5196.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10558.15},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5196.66,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Myocardial Infarction, Expired With Mcc","code_information":[{"code":"283","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11896.6,"maximum":29083.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29083.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14870.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18175.26},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22270.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14870.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26492.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14870.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15168.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14870.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14870.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11896.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14870.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14870.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14870.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27488.46},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14870.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc","code_information":[{"code":"282","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4342.91,"maximum":10939.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10939.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5428.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6836.45},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8376.98},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5428.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9964.73},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5428.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5537.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5428.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5428.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4342.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5428.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5428.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5428.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10339.53},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5428.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5361.62,"10th_percentile":5361.62,"90th_percentile":5361.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10904.99,"10th_percentile":10904.99,"90th_percentile":10904.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5373.9,"10th_percentile":5369.1,"90th_percentile":5377.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5266.35,"10th_percentile":5266.35,"90th_percentile":5266.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Myocardial Infarction, Discharged Alive With Cc","code_information":[{"code":"281","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5520.08,"maximum":13615.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13615.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6900.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8508.97},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10426.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6900.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12402.56},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6900.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7038.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6900.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6900.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5520.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6900.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6900.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6900.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12869.06},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6900.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6854.4,"10th_percentile":6854.4,"90th_percentile":6854.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":106009.76,"10th_percentile":106009.76,"90th_percentile":106009.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":4840.44,"10th_percentile":4840.44,"90th_percentile":4840.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6675.08,"10th_percentile":4197.1,"90th_percentile":6831.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6691.01,"10th_percentile":6683.28,"90th_percentile":6715.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Myocardial Infarction, Discharged Alive With Mcc","code_information":[{"code":"280","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9634.16,"maximum":23889.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23889.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12042.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14929.38},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18293.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12042.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21760.87},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12042.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12283.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12042.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12042.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9634.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12042.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12042.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12042.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22579.36},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12042.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9557.68,"10th_percentile":6814.9,"90th_percentile":11922.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30238.89,"10th_percentile":30238.89,"90th_percentile":30238.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11708.39,"10th_percentile":11708.39,"90th_percentile":11708.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11848.95,"10th_percentile":5806.35,"90th_percentile":11909.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8531.91,"10th_percentile":2750.0,"90th_percentile":11715.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures Without Mcc","code_information":[{"code":"279","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21659.89,"maximum":61254.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61254.79},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27074.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":38280.63},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46906.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27074.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55797.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27074.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27616.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27074.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27074.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21659.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27074.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27074.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27074.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57896.04},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27074.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25938.27,"10th_percentile":25938.27,"90th_percentile":25938.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures With Mcc","code_information":[{"code":"278","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":33430.37,"maximum":94123.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":94123.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41787.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":58821.49},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72076.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41787.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":85737.44},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41787.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42623.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41787.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41787.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33430.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41787.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41787.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41787.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":88962.27},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41787.96,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Defibrillator Implant Without Mcc","code_information":[{"code":"277","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27738.52,"maximum":69553.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69553.46},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34673.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43466.81},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53261.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34673.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63356.65},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34673.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35366.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34673.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34673.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27738.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34673.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34673.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34673.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65739.67},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34673.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":57460.61,"10th_percentile":57460.61,"90th_percentile":57460.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":34269.85,"10th_percentile":34269.85,"90th_percentile":34269.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator","code_information":[{"code":"276","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36075.39,"maximum":91960.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":91960.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45094.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":57469.59},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70419.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45094.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":83766.91},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45094.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45996.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45094.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45094.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36075.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45094.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45094.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45094.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":86917.63},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45094.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":44586.49,"10th_percentile":44586.49,"90th_percentile":44586.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc","code_information":[{"code":"275","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":42824.89,"maximum":106118.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":106118.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53531.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":66317.69},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81261.71},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53531.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":96663.79},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53531.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54601.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53531.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53531.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42824.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":53531.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53531.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53531.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":100299.6},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53531.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":58344.47,"10th_percentile":58344.47,"90th_percentile":58344.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous And Other Intracardiac Procedures Without Mcc","code_information":[{"code":"274","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19769.82,"maximum":49403.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49403.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24712.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30874.31},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37831.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24712.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45001.99},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24712.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25206.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24712.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24712.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19769.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24712.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24712.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24712.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46694.65},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24712.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":1125.0,"10th_percentile":1125.0,"90th_percentile":1125.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24412.76,"10th_percentile":24406.96,"90th_percentile":28307.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":64590.37,"10th_percentile":61182.19,"90th_percentile":131023.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23641.26,"10th_percentile":23641.26,"90th_percentile":23641.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":38392.23,"10th_percentile":38392.23,"90th_percentile":38392.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"19","median_amount":24411.86,"10th_percentile":24405.26,"90th_percentile":24428.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":49128.62,"10th_percentile":49128.62,"90th_percentile":49128.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23934.24,"10th_percentile":23926.34,"90th_percentile":23937.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous And Other Intracardiac Procedures With Mcc","code_information":[{"code":"273","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24777.58,"maximum":63732.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63732.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30971.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39828.97},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48804.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30971.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58054.19},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30971.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31591.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30971.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30971.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24777.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30971.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30971.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30971.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60237.78},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30971.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30589.58,"10th_percentile":30589.58,"90th_percentile":30589.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28709.36,"10th_percentile":28709.36,"90th_percentile":28709.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":58263.65,"10th_percentile":58263.65,"90th_percentile":58263.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30606.71,"10th_percentile":30594.07,"90th_percentile":31210.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30041.97,"10th_percentile":30006.09,"90th_percentile":30049.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Major Cardiovascular Procedures Without Cc/Mcc","code_information":[{"code":"272","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15333.22,"maximum":36851.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36851.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19166.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23029.72},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28219.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19166.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33567.81},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19166.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19549.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19166.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19166.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15333.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19166.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19166.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19166.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34830.4},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19166.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1416.61,"10th_percentile":1416.61,"90th_percentile":1416.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":35777.74,"10th_percentile":35777.74,"90th_percentile":35777.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Major Cardiovascular Procedures With Cc","code_information":[{"code":"271","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21358.99,"maximum":53338.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53338.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26698.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33333.51},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40844.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26698.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48586.48},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26698.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27232.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26698.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26698.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21358.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26698.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26698.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26698.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50413.96},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26698.74,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26384.14,"10th_percentile":26384.14,"90th_percentile":26384.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":36896.61,"10th_percentile":36896.61,"90th_percentile":50677.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":68431.11,"10th_percentile":68431.11,"90th_percentile":68431.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26372.64,"10th_percentile":18934.49,"90th_percentile":26389.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Major Cardiovascular Procedures With Mcc","code_information":[{"code":"270","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31689.24,"maximum":78086.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":78086.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39611.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":48799.39},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59795.84},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39611.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":71129.35},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39611.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40403.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39611.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39611.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31689.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39611.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39611.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39611.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73804.73},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39611.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":43941.64,"10th_percentile":43941.64,"90th_percentile":43941.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":39166.22,"10th_percentile":39166.22,"90th_percentile":39166.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":85821.82,"10th_percentile":85821.82,"90th_percentile":85821.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":73885.91,"10th_percentile":73885.91,"90th_percentile":73885.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":38391.29,"10th_percentile":38391.29,"90th_percentile":38391.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc","code_information":[{"code":"269","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25364.37,"maximum":63143.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63143.74},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31705.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39461.11},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48353.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31705.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57518.0},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31705.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32339.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31705.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31705.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25364.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31705.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31705.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31705.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59681.42},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31705.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":90832.64,"10th_percentile":90832.64,"90th_percentile":90832.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":31317.47,"10th_percentile":31317.47,"90th_percentile":31317.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc","code_information":[{"code":"268","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":41308.38,"maximum":106245.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":106245.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51635.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":66397.38},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81359.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51635.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":96779.94},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51635.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52668.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51635.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51635.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41308.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51635.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51635.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51635.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":100420.12},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51635.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc","code_information":[{"code":"267","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28593.17,"maximum":69999.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69999.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35741.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43745.71},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53603.37},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35741.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63763.18},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35741.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36456.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35741.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35741.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28593.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35741.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35741.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35741.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66161.5},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35741.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":35300.2,"10th_percentile":35300.2,"90th_percentile":35316.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":37819.36,"10th_percentile":37819.36,"90th_percentile":37819.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":88222.51,"10th_percentile":88222.51,"90th_percentile":88222.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":35303.27,"10th_percentile":35297.67,"90th_percentile":35304.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":34608.68,"10th_percentile":33288.25,"90th_percentile":54433.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc","code_information":[{"code":"266","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36806.92,"maximum":88033.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":88033.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46008.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":55015.95},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67413.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46008.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":80190.52},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46008.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46928.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46008.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46008.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36806.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":46008.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46008.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46008.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":83206.72},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46008.65,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":71088.35,"10th_percentile":71088.35,"90th_percentile":71088.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":376347.55,"10th_percentile":376347.55,"90th_percentile":376347.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":45461.94,"10th_percentile":45461.94,"90th_percentile":66918.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":42404.46,"10th_percentile":42404.46,"90th_percentile":42404.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aicd Lead Procedures","code_information":[{"code":"265","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21730.76,"maximum":48282.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48282.64},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27163.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30173.8},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36973.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27163.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43980.94},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27163.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27706.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27163.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27163.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21730.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27163.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27163.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27163.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45635.19},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27163.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vein Ligation And Stripping","code_information":[{"code":"263","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18362.62,"maximum":48069.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48069.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22953.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30040.37},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36809.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22953.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43786.45},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22953.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23412.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22953.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22953.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18362.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22953.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22953.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22953.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45433.39},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22953.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/Mcc","code_information":[{"code":"257","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6559.71,"maximum":15498.66,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15498.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8199.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9685.75},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11868.34},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8199.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14117.82},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8199.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8363.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8199.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8199.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6559.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8199.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8199.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8199.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14648.83},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8199.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Upper Limb And Toe Amputation For Circulatory System Disorders With Cc","code_information":[{"code":"256","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10197.52,"maximum":24775.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24775.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12746.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15483.49},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18972.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12746.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22568.53},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12746.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13001.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12746.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12746.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10197.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12746.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12746.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12746.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23417.39},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12746.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc","code_information":[{"code":"255","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16200.47,"maximum":41950.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41950.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20250.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26216.29},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32123.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20250.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38212.53},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20250.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20655.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20250.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20250.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16200.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20250.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20250.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20250.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39649.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20250.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Vascular Procedures Without Cc/Mcc","code_information":[{"code":"254","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10700.82,"maximum":26630.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26630.77},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13376.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16642.66},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20392.92},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13376.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24258.13},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13376.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13643.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13376.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13376.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10700.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13376.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13376.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13376.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25170.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13376.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":850.0,"10th_percentile":850.0,"90th_percentile":850.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Vascular Procedures With Cc","code_information":[{"code":"253","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15589.06,"maximum":38943.12,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38943.12},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19486.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24337.15},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29821.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19486.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35473.51},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19486.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19876.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19486.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19486.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15589.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19486.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19486.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19486.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36807.77},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19486.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13226.65,"10th_percentile":13226.65,"90th_percentile":13226.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":36387.3,"10th_percentile":36387.3,"90th_percentile":36387.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19247.93,"10th_percentile":19247.93,"90th_percentile":19250.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Vascular Procedures With Mcc","code_information":[{"code":"252","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20950.58,"maximum":51630.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51630.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26188.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32266.07},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39536.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26188.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47030.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26188.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26711.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26188.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26188.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20950.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26188.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26188.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26188.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48799.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26188.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":37256.86,"10th_percentile":37256.86,"90th_percentile":37256.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":42294.28,"10th_percentile":42294.28,"90th_percentile":42294.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19290.34,"10th_percentile":19290.34,"90th_percentile":19290.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25388.37,"10th_percentile":25388.37,"90th_percentile":25388.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc","code_information":[{"code":"251","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8975.9,"maximum":24672.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24672.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11219.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15418.62},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18893.06},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11219.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22473.98},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11219.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11444.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11219.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11219.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8975.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11219.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11219.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11219.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23319.3},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11219.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10523.42,"10th_percentile":10523.42,"90th_percentile":10523.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11081.11,"10th_percentile":11081.11,"90th_percentile":11081.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc","code_information":[{"code":"250","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13108.01,"maximum":34683.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34683.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16385.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21675.03},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26559.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16385.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31593.24},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16385.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16712.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16385.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16385.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13108.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16385.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16385.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16385.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32781.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16385.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aicd Generator Procedures","code_information":[{"code":"245","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27401.58,"maximum":68889.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":68889.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34251.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43051.69},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52752.95},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34251.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62751.58},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34251.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34937.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34251.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34251.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27401.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34251.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34251.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34251.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65111.85},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34251.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33191.29,"10th_percentile":33191.29,"90th_percentile":33191.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Permanent Cardiac Pacemaker Implant Without Cc/Mcc","code_information":[{"code":"244","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10855.77,"maximum":26154.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26154.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13569.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16345.22},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20028.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13569.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23824.58},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13569.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13841.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13569.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13569.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10855.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13569.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13569.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13569.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24720.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13569.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13417.99,"10th_percentile":13417.99,"90th_percentile":13417.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32747.59,"10th_percentile":32747.59,"90th_percentile":32747.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13403.39,"10th_percentile":13402.99,"90th_percentile":13414.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13147.2,"10th_percentile":13147.2,"90th_percentile":13152.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Permanent Cardiac Pacemaker Implant With Cc","code_information":[{"code":"243","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12798.1,"maximum":31252.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31252.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15997.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19530.87},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23931.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15997.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28467.95},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15997.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16317.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15997.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15997.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12798.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15997.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15997.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15997.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29538.71},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15997.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15800.12,"10th_percentile":15800.12,"90th_percentile":15800.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":42467.53,"10th_percentile":42467.53,"90th_percentile":42467.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15801.72,"10th_percentile":15800.23,"90th_percentile":15822.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11068.62,"10th_percentile":11068.62,"90th_percentile":15543.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Permanent Cardiac Pacemaker Implant With Mcc","code_information":[{"code":"242","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19175.82,"maximum":46312.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46312.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23969.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28942.35},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35464.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23969.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42185.99},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23969.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24449.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23969.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23969.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19175.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23969.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23969.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23969.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43772.73},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23969.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23687.42,"10th_percentile":23687.42,"90th_percentile":23687.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22561.09,"10th_percentile":22561.09,"90th_percentile":22561.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9872.77,"10th_percentile":9872.77,"90th_percentile":9872.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":47652.54,"10th_percentile":47652.54,"90th_percentile":47652.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23244.47,"10th_percentile":23244.47,"90th_percentile":23262.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc/Mcc","code_information":[{"code":"241","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8314.65,"maximum":21978.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21978.06},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10393.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13734.99},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16830.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10393.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20019.94},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10393.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10601.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10393.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10393.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8314.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10393.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10393.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10393.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20772.95},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10393.31,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10292.02,"10th_percentile":10292.02,"90th_percentile":10292.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc","code_information":[{"code":"240","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17119.98,"maximum":43699.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43699.62},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21399.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27309.68},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33463.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21399.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39806.23},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21399.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21827.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21399.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21399.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17119.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21399.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21399.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21399.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41303.46},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21399.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20279.1,"10th_percentile":20279.1,"90th_percentile":20279.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc","code_information":[{"code":"239","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":29559.53,"maximum":74151.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74151.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36949.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":46340.19},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56782.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36949.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67544.86},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36949.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37688.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36949.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36949.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29559.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36949.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36949.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36949.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70085.42},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36949.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":51840.27,"10th_percentile":51840.27,"90th_percentile":51840.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13173.41,"10th_percentile":13173.41,"90th_percentile":13173.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Bypass Without Cardiac Catheterization Without Mcc","code_information":[{"code":"236","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25157.76,"maximum":64315.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64315.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31447.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40193.13},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49250.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31447.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58584.98},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31447.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32076.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31447.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31447.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25157.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31447.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31447.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31447.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60788.53},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31447.2,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":62424.34,"10th_percentile":62424.34,"90th_percentile":62424.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":31098.84,"10th_percentile":31098.84,"90th_percentile":31098.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":82010.96,"10th_percentile":69152.11,"90th_percentile":86949.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30571.34,"10th_percentile":30571.34,"90th_percentile":30571.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":53023.02,"10th_percentile":47291.71,"90th_percentile":69466.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":31091.01,"10th_percentile":31057.61,"90th_percentile":31105.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":62517.84,"10th_percentile":62517.84,"90th_percentile":62517.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30447.58,"10th_percentile":26282.43,"90th_percentile":30504.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Bypass Without Cardiac Catheterization With Mcc","code_information":[{"code":"235","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":35246.57,"maximum":86775.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":86775.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44058.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":54229.27},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66449.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44058.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79043.87},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44058.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44939.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44058.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44058.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35246.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":44058.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44058.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44058.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":82016.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44058.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":89265.66,"10th_percentile":89265.66,"90th_percentile":89265.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":43566.17,"10th_percentile":43566.17,"90th_percentile":71466.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":418.68,"10th_percentile":418.68,"90th_percentile":418.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc","code_information":[{"code":"234","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32808.75,"maximum":81609.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81609.29},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41010.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51000.99},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62493.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41010.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74338.37},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41010.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41831.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41010.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41010.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32808.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41010.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41010.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41010.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77134.46},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41010.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":178952.46,"10th_percentile":178952.46,"90th_percentile":178952.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":39516.59,"10th_percentile":39516.59,"90th_percentile":39516.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":85828.11,"10th_percentile":68009.54,"90th_percentile":98656.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":37173.73,"10th_percentile":37173.73,"90th_percentile":37173.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":50079.33,"10th_percentile":50079.33,"90th_percentile":50079.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":40512.8,"10th_percentile":40500.79,"90th_percentile":40553.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":76554.28,"10th_percentile":76554.28,"90th_percentile":76554.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":38757.34,"10th_percentile":29101.88,"90th_percentile":39766.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc","code_information":[{"code":"233","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":45916.75,"maximum":118847.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":118847.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57395.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":74272.55},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":91009.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57395.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":108258.69},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57395.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":58543.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57395.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57395.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45916.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":57395.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57395.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57395.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":112330.62},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57395.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":113331.72,"10th_percentile":113331.72,"90th_percentile":113331.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26979.85,"10th_percentile":26979.85,"90th_percentile":26979.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":54595.14,"10th_percentile":54595.14,"90th_percentile":54595.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2453.87,"10th_percentile":2453.87,"90th_percentile":56736.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":62743.29,"10th_percentile":62743.29,"90th_percentile":62743.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Bypass With Ptca Without Mcc","code_information":[{"code":"232","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36411.73,"maximum":92333.66,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":92333.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45514.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":57703.09},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70705.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45514.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":84107.26},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45514.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46424.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45514.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45514.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36411.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45514.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45514.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45514.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":87270.78},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45514.66,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coronary Bypass With Ptca With Mcc","code_information":[{"code":"231","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":50629.63,"maximum":130105.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":130105.44},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63287.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":81308.22},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":99630.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63287.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":118513.8},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63287.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":64552.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63287.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63287.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50629.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":63287.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63287.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63287.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":122971.45},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63287.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":62554.69,"10th_percentile":62554.69,"90th_percentile":62554.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Cardiothoracic Procedures Without Mcc","code_information":[{"code":"229","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18915.77,"maximum":51010.81,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51010.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23644.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31878.75},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39062.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23644.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46466.04},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23644.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24117.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23644.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23644.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18915.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23644.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23644.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23644.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48213.77},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23644.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23421.7,"10th_percentile":23421.7,"90th_percentile":23421.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21448.35,"10th_percentile":21448.35,"90th_percentile":21448.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23360.79,"10th_percentile":23360.79,"90th_percentile":23390.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22903.75,"10th_percentile":22903.75,"90th_percentile":22914.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Cardiothoracic Procedures With Mcc","code_information":[{"code":"228","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":29713.88,"maximum":73630.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73630.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37142.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":46014.96},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56383.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37142.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67070.8},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37142.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37885.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37142.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37142.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29713.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37142.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37142.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37142.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69593.52},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37142.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":44092.79,"10th_percentile":44092.79,"90th_percentile":44092.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":111559.56,"10th_percentile":111559.56,"90th_percentile":165158.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":36697.29,"10th_percentile":36697.29,"90th_percentile":42370.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":36019.51,"10th_percentile":36019.51,"90th_percentile":36019.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization Without Cc/M","code_information":[{"code":"221","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30271.23,"maximum":69885.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69885.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37839.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43674.36},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53515.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37839.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63659.18},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37839.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":38595.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37839.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37839.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":30271.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37839.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37839.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37839.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66053.59},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37839.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":69328.43,"10th_percentile":69328.43,"90th_percentile":69328.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":75224.99,"10th_percentile":75224.99,"90th_percentile":75224.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":36639.1,"10th_percentile":36639.1,"90th_percentile":36639.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Cc","code_information":[{"code":"220","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32028.58,"maximum":81640.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81640.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40035.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51020.45},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62517.39},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40035.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74366.74},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40035.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40836.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40035.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40035.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32028.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40035.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40035.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40035.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77163.89},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40035.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":116017.42,"10th_percentile":100734.74,"90th_percentile":137417.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":37699.33,"10th_percentile":37699.33,"90th_percentile":37699.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":38102.81,"10th_percentile":38102.81,"90th_percentile":38102.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":38797.46,"10th_percentile":38797.46,"90th_percentile":38797.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Mcc","code_information":[{"code":"219","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":46115.55,"maximum":113284.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":113284.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57644.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":70795.95},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":86749.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57644.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":103191.24},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57644.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":58797.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57644.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57644.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":46115.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":57644.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57644.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57644.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":107072.57},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57644.44,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":118830.88,"10th_percentile":118830.88,"90th_percentile":131663.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":98067.61,"10th_percentile":98067.61,"90th_percentile":127678.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization Without Cc/Mcc","code_information":[{"code":"218","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":39490.98,"maximum":100900.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":100900.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":63056.98},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77266.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":91911.03},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50351.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39490.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":95368.07},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Cc","code_information":[{"code":"217","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":39490.98,"maximum":100900.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":100900.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":63056.98},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77266.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":91911.03},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50351.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39490.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":95368.07},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49363.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2124.08,"10th_percentile":2124.08,"90th_percentile":2124.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":47833.03,"10th_percentile":47833.03,"90th_percentile":47833.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc","code_information":[{"code":"216","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":58755.1,"maximum":146524.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":146524.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":73443.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":91569.39},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":112203.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":73443.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":133470.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":73443.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":74912.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":73443.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":73443.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":58755.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":73443.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":73443.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":73443.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":138490.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":73443.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":128620.21,"10th_percentile":128620.21,"90th_percentile":128620.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Heart Assist System Implant","code_information":[{"code":"215","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":59801.33,"maximum":150369.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":150369.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":74751.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":93972.07},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":115147.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":74751.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":136972.45},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":74751.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":76246.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":74751.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":74751.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":59801.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":74751.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":74751.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":74751.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":142124.38},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":74751.66,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":70749.75,"10th_percentile":70749.75,"90th_percentile":70749.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":121966.64,"10th_percentile":121966.64,"90th_percentile":121966.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":128405.6,"10th_percentile":128405.6,"90th_percentile":128405.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endovascular Abdominal Aorta With Iliac Branch Procedures","code_information":[{"code":"213","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":34275.41,"maximum":86700.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":86700.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42844.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":54182.94},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66392.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42844.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":78976.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42844.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43701.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42844.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42844.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34275.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42844.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42844.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42844.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81946.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42844.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":42335.33,"10th_percentile":42335.33,"90th_percentile":42335.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Concomitant Aortic And Mitral Valve Procedures","code_information":[{"code":"212","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":65309.39,"maximum":169644.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":169644.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":81636.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":106017.87},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":129907.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":81636.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":154530.25},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":81636.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":83269.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":81636.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":81636.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":65309.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":81636.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":81636.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":81636.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":160342.58},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":81636.74,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Pacemaker Revision Or Device Replacement Without Mcc","code_information":[{"code":"211","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16767.75,"maximum":26830.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26830.94},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16767.75},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20546.2},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24440.46},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25359.73}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Pacemaker Revision Or Device Replacement With Mcc","code_information":[{"code":"210","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30259.98,"maximum":48420.53,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48420.53},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30259.98},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37078.76},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44106.54},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45765.52}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complex Aortic Arch Procedures","code_information":[{"code":"209","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":67980.25,"maximum":170750.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":170750.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":84975.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":106709.11},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":130754.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":84975.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":155537.8},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":84975.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":86674.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":84975.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":84975.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":67980.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":84975.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":84975.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":84975.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":161388.03},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":84975.31,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory System Diagnosis With Ventilator Support <=96 Hours","code_information":[{"code":"208","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16508.58,"maximum":40789.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40789.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20635.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25490.77},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31234.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20635.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37155.01},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20635.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21048.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20635.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20635.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16508.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20635.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20635.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20635.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38552.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20635.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":290.0,"10th_percentile":290.0,"90th_percentile":290.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28517.76,"10th_percentile":28517.76,"90th_percentile":94210.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":20379.02,"10th_percentile":20379.02,"90th_percentile":20379.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20411.02,"10th_percentile":20411.02,"90th_percentile":20435.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":38027.38,"10th_percentile":38027.38,"90th_percentile":38027.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19984.44,"10th_percentile":19979.44,"90th_percentile":20016.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory System Diagnosis With Ventilator Support >96 Hours","code_information":[{"code":"207","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":38646.54,"maximum":94854.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":94854.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48308.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":59278.31},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72636.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48308.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":86403.28},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48308.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49274.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48308.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48308.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":38646.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":48308.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48308.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48308.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":89653.16},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":48308.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":83168.5,"10th_percentile":83168.5,"90th_percentile":83168.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":96037.9,"10th_percentile":96037.9,"90th_percentile":96037.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":44942.66,"10th_percentile":44942.66,"90th_percentile":44942.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Respiratory System Diagnoses Without Mcc","code_information":[{"code":"206","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5652.21,"maximum":13722.39,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13722.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7065.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8575.68},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10508.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7065.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12499.8},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7065.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7206.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7065.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7065.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5652.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7065.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7065.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7065.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12969.96},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7065.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":777.0,"10th_percentile":777.0,"90th_percentile":777.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6228.48,"10th_percentile":6228.48,"90th_percentile":6228.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":2792.0,"10th_percentile":2792.0,"90th_percentile":2792.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6984.36,"10th_percentile":6984.36,"90th_percentile":6984.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1062.44,"10th_percentile":1062.44,"90th_percentile":1062.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6840.56,"10th_percentile":6840.56,"90th_percentile":6859.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Respiratory System Diagnoses With Mcc","code_information":[{"code":"205","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10996.91,"maximum":27050.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27050.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13746.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16904.89},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20714.24},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13746.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24640.35},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13746.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14021.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13746.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13746.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10996.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13746.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13746.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13746.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25567.14},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13746.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6978.03,"10th_percentile":6978.03,"90th_percentile":6978.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13622.95,"10th_percentile":13622.95,"90th_percentile":13622.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":740.0,"10th_percentile":740.0,"90th_percentile":740.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Signs And Symptoms","code_information":[{"code":"204","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4849.21,"maximum":12170.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12170.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6061.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7605.53},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9319.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6061.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11085.72},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6061.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6182.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6061.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6061.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4849.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6061.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6061.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6061.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11502.69},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6061.51,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11505.45,"10th_percentile":11505.45,"90th_percentile":11505.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":1828.72,"10th_percentile":1828.72,"90th_percentile":8504.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bronchitis And Asthma Without Cc/Mcc","code_information":[{"code":"203","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4023.99,"maximum":9650.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9650.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5029.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6031.24},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7390.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5029.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8791.06},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5029.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5130.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5029.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5029.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4023.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5029.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5029.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5029.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9121.71},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5029.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":9461.07,"10th_percentile":9461.07,"90th_percentile":9461.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7438.0,"10th_percentile":7438.0,"90th_percentile":9547.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":6482.38,"10th_percentile":6482.38,"90th_percentile":6659.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1262.41,"10th_percentile":1262.41,"90th_percentile":1262.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1699.03,"10th_percentile":1699.03,"90th_percentile":1699.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":9999.75,"10th_percentile":9999.75,"90th_percentile":9999.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4881.73,"10th_percentile":4881.73,"90th_percentile":4881.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bronchitis And Asthma With Cc/Mcc","code_information":[{"code":"202","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5832.98,"maximum":14044.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14044.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7291.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8776.76},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10754.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7291.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12792.88},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7291.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7437.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7291.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7291.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5832.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7291.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7291.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7291.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13274.06},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7291.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7201.22,"10th_percentile":7200.54,"90th_percentile":7202.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13839.6,"10th_percentile":13839.6,"90th_percentile":18308.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5548.17,"10th_percentile":5548.17,"90th_percentile":6703.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":9360.45,"10th_percentile":2469.99,"90th_percentile":12552.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1699.03,"10th_percentile":1699.03,"90th_percentile":1699.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7202.94,"10th_percentile":7202.94,"90th_percentile":7217.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":302.41,"10th_percentile":302.41,"90th_percentile":302.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1699.03,"10th_percentile":1699.03,"90th_percentile":1699.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":1357.0,"10th_percentile":1357.0,"90th_percentile":1357.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7069.72,"10th_percentile":7069.72,"90th_percentile":7069.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pneumothorax Without Cc/Mcc","code_information":[{"code":"201","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4294.86,"maximum":10055.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10055.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5368.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6284.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7700.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5368.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9159.77},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5368.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5475.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5368.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5368.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4294.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5368.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5368.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5368.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9504.29},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5368.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":10097.93,"10th_percentile":10097.93,"90th_percentile":10097.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11498.75,"10th_percentile":11498.75,"90th_percentile":11498.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":9242.67,"10th_percentile":9242.67,"90th_percentile":9242.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pneumothorax With Cc","code_information":[{"code":"200","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6602.35,"maximum":15970.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15970.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8252.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9980.41},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12229.39},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8252.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14547.31},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8252.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8418.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8252.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8252.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6602.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8252.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8252.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8252.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15094.48},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8252.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20222.9,"10th_percentile":20222.9,"90th_percentile":20222.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8165.28,"10th_percentile":8165.28,"90th_percentile":8165.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7998.97,"10th_percentile":7998.97,"90th_percentile":7999.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pneumothorax With Mcc","code_information":[{"code":"199","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10595.11,"maximum":25671.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25671.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13243.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16043.15},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19658.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13243.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23384.29},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13243.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13508.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13243.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13243.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10595.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13243.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13243.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13243.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24263.84},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13243.89,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":22816.5,"10th_percentile":22816.5,"90th_percentile":22816.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13079.16,"10th_percentile":13079.16,"90th_percentile":13079.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Interstitial Lung Disease Without Cc/Mcc","code_information":[{"code":"198","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4301.46,"maximum":10758.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10758.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6723.41},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8238.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9799.95},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5484.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4301.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10168.56},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5376.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10205.85,"10th_percentile":10205.85,"90th_percentile":10205.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Interstitial Lung Disease With Cc","code_information":[{"code":"197","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5700.26,"maximum":14072.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14072.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7125.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8794.36},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10776.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7125.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12818.54},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7125.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7267.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7125.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7125.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5700.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7125.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7125.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7125.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13300.69},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7125.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7054.16,"10th_percentile":7054.16,"90th_percentile":7054.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Interstitial Lung Disease With Mcc","code_information":[{"code":"196","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11334.45,"maximum":27185.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27185.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14168.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16989.21},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20817.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14168.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24763.25},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14168.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14451.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14168.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14168.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11334.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14168.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14168.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14168.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25694.67},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14168.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14005.13,"10th_percentile":14005.13,"90th_percentile":14005.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14026.81,"10th_percentile":14026.81,"90th_percentile":14047.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13772.07,"10th_percentile":13772.07,"90th_percentile":13772.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Simple Pneumonia And Pleurisy Without Cc/Mcc","code_information":[{"code":"195","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3774.74,"maximum":8988.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8988.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4718.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5617.05},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6882.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4718.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8187.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4718.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4812.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4718.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4718.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3774.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4718.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4718.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4718.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8495.29},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4718.43,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":8103.28,"10th_percentile":8103.28,"90th_percentile":8103.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4659.73,"10th_percentile":4659.73,"90th_percentile":4676.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":523.67,"10th_percentile":523.67,"90th_percentile":6520.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":5961.01,"10th_percentile":2135.0,"90th_percentile":8123.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1825.16,"10th_percentile":1825.16,"90th_percentile":1825.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":185.41,"10th_percentile":185.41,"90th_percentile":185.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1825.16,"10th_percentile":1825.16,"90th_percentile":1825.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":8807.8,"10th_percentile":8807.8,"90th_percentile":8807.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4568.8,"10th_percentile":4568.8,"90th_percentile":4568.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Simple Pneumonia And Pleurisy With Cc","code_information":[{"code":"194","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4840.2,"maximum":11692.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11692.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6050.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7307.17},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8953.76},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6050.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10650.83},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6050.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6171.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6050.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6050.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4840.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6050.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6050.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6050.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11051.44},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6050.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":11380.11,"10th_percentile":11380.11,"90th_percentile":11380.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5975.56,"10th_percentile":5975.0,"90th_percentile":5991.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11484.08,"10th_percentile":10621.63,"90th_percentile":14203.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5111.74,"10th_percentile":5111.74,"90th_percentile":5561.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":7445.72,"10th_percentile":7445.72,"90th_percentile":10416.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1825.16,"10th_percentile":1825.16,"90th_percentile":3157.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"17","median_amount":5978.99,"10th_percentile":600.0,"90th_percentile":6006.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":331.68,"10th_percentile":331.68,"90th_percentile":331.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1825.16,"10th_percentile":1825.16,"90th_percentile":1825.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":12028.06,"10th_percentile":12028.06,"90th_percentile":12028.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5857.84,"10th_percentile":729.14,"90th_percentile":5887.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Simple Pneumonia And Pleurisy With Mcc","code_information":[{"code":"193","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7894.23,"maximum":19014.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19014.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9867.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11882.72},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14560.37},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9867.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17320.09},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9867.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10065.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9867.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9867.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7894.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9867.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9867.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9867.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17971.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9867.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6009.79,"10th_percentile":4999.26,"90th_percentile":9752.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13636.9,"10th_percentile":12730.2,"90th_percentile":24839.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8312.97,"10th_percentile":7378.9,"90th_percentile":9347.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":16988.62,"10th_percentile":16988.62,"90th_percentile":16988.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"41","median_amount":9746.25,"10th_percentile":4050.0,"90th_percentile":9785.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":18420.0,"10th_percentile":18420.0,"90th_percentile":18420.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"15","median_amount":9564.98,"10th_percentile":1200.0,"90th_percentile":9603.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chronic Obstructive Pulmonary Disease Without Cc/Mcc","code_information":[{"code":"192","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3855.82,"maximum":9318.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9318.77},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4819.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5823.68},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7135.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4819.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8488.52},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4819.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4916.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4819.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4819.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3855.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4819.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4819.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4819.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8807.8},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4819.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4763.82,"10th_percentile":4763.82,"90th_percentile":4763.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":4684.5,"10th_percentile":4684.5,"90th_percentile":4684.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":130.0,"10th_percentile":130.0,"90th_percentile":130.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chronic Obstructive Pulmonary Disease With Cc","code_information":[{"code":"191","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5063.02,"maximum":12245.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12245.62},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6328.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7652.79},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9377.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6328.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11154.61},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6328.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6455.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6328.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6328.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5063.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6328.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6328.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6328.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11574.16},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6328.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6265.85,"10th_percentile":6265.85,"90th_percentile":6265.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11512.75,"10th_percentile":11512.75,"90th_percentile":11512.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4997.51,"10th_percentile":4997.51,"90th_percentile":4997.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2045.44,"10th_percentile":2045.44,"90th_percentile":2045.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6262.05,"10th_percentile":6250.85,"90th_percentile":12099.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":227.86,"10th_percentile":227.86,"90th_percentile":227.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6138.36,"10th_percentile":6138.36,"90th_percentile":6138.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chronic Obstructive Pulmonary Disease With Mcc","code_information":[{"code":"190","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6652.8,"maximum":15937.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15937.54},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8316.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9960.02},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12204.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8316.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14517.6},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8316.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8482.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8316.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8316.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6652.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8316.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8316.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8316.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15063.65},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8316.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5974.99,"10th_percentile":4759.82,"90th_percentile":6290.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11492.39,"10th_percentile":9692.39,"90th_percentile":12530.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7929.4,"10th_percentile":7929.4,"90th_percentile":8085.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":14514.78,"10th_percentile":14514.78,"90th_percentile":14514.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2488.89,"10th_percentile":2488.89,"90th_percentile":2488.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"14","median_amount":7476.74,"10th_percentile":523.73,"90th_percentile":8241.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":430.61,"10th_percentile":430.61,"90th_percentile":430.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8071.8,"10th_percentile":740.0,"90th_percentile":8106.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pulmonary Edema And Respiratory Failure","code_information":[{"code":"189","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7419.76,"maximum":17951.05,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17951.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9274.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11218.35},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13746.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9274.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16351.71},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9274.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9460.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9274.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9274.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7419.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9274.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9274.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9274.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16966.75},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9274.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9160.71,"10th_percentile":9160.71,"90th_percentile":9165.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23288.53,"10th_percentile":12817.28,"90th_percentile":96748.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8791.39,"10th_percentile":8791.39,"90th_percentile":9016.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":15967.55,"10th_percentile":15967.55,"90th_percentile":15967.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9161.81,"10th_percentile":9159.33,"90th_percentile":20067.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":371.52,"10th_percentile":371.52,"90th_percentile":371.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":17312.9,"10th_percentile":17312.9,"90th_percentile":17312.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8994.54,"10th_percentile":8979.74,"90th_percentile":9034.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pleural Effusion Without Cc/Mcc","code_information":[{"code":"188","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4307.47,"maximum":9861.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9861.44},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5384.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6162.82},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7551.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5384.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8982.84},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5384.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5492.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5384.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5384.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4307.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5384.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5384.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5384.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9320.71},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5384.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pleural Effusion With Cc","code_information":[{"code":"187","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5940.5,"maximum":14831.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14831.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7425.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9268.78},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11357.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7425.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13510.05},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7425.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7574.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7425.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7425.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5940.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7425.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7425.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7425.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14018.2},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7425.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6064.48,"10th_percentile":6064.48,"90th_percentile":6064.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7357.24,"10th_percentile":7357.24,"90th_percentile":7357.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pleural Effusion With Mcc","code_information":[{"code":"186","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9360.29,"maximum":23487.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23487.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11700.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14678.27},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17985.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11700.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21394.85},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11700.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11934.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11700.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11700.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9360.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11700.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11700.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11700.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22199.58},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11700.36,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":315.08,"10th_percentile":315.08,"90th_percentile":315.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10024.5,"10th_percentile":10024.5,"90th_percentile":10024.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Chest Trauma Without Cc/Mcc","code_information":[{"code":"185","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4723.69,"maximum":11434.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11434.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5904.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7145.94},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8756.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5904.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10415.83},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5904.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6022.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5904.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5904.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4723.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5904.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5904.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5904.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10807.6},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5904.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Chest Trauma With Cc","code_information":[{"code":"184","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6390.94,"maximum":15783.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15783.34},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7988.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9863.66},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12086.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7988.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14377.14},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7988.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8148.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7988.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7988.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6390.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7988.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7988.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7988.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14917.9},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7988.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Chest Trauma With Mcc","code_information":[{"code":"183","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9188.52,"maximum":22098.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22098.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11485.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13810.05},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16922.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11485.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20129.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11485.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11715.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11485.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11485.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9188.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11485.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11485.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11485.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20886.47},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11485.65,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11352.77,"10th_percentile":11352.77,"90th_percentile":11352.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11358.84,"10th_percentile":11358.84,"90th_percentile":11358.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Neoplasms Without Cc/Mcc","code_information":[{"code":"182","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4527.29,"maximum":11025.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11025.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5659.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6890.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8442.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5659.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10043.06},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5659.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5772.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5659.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5659.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4527.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5659.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5659.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5659.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10420.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5659.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5595.24,"10th_percentile":5595.24,"90th_percentile":5595.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":139.2,"10th_percentile":139.2,"90th_percentile":139.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":140.0,"10th_percentile":140.0,"90th_percentile":140.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Neoplasms With Cc","code_information":[{"code":"181","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6432.38,"maximum":16213.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16213.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8040.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10132.37},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12415.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8040.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14768.81},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8040.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8201.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8040.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8040.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6432.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8040.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8040.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8040.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15324.31},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8040.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7951.31,"10th_percentile":7951.31,"90th_percentile":7951.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11519.36,"10th_percentile":11519.36,"90th_percentile":11519.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7952.45,"10th_percentile":7952.45,"90th_percentile":7952.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Neoplasms With Mcc","code_information":[{"code":"180","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10606.52,"maximum":26392.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26392.06},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16493.48},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20210.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24040.68},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13523.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10606.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13258.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24944.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13258.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13094.73,"10th_percentile":13094.73,"90th_percentile":13094.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12229.47,"10th_percentile":12229.47,"90th_percentile":12229.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13114.79,"10th_percentile":13095.63,"90th_percentile":13797.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":15559.74,"10th_percentile":15559.74,"90th_percentile":15559.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12851.31,"10th_percentile":12851.31,"90th_percentile":12851.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Infections And Inflammations Without Cc/Mcc","code_information":[{"code":"179","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4534.5,"maximum":10888.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10888.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6804.95},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8338.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9918.81},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5781.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4534.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5668.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10291.88},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5668.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5601.61,"10th_percentile":5601.61,"90th_percentile":5601.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5285.25,"10th_percentile":5285.25,"90th_percentile":5285.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":355.21,"10th_percentile":355.21,"90th_percentile":355.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Infections And Inflammations With Cc","code_information":[{"code":"178","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5861.82,"maximum":14444.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14444.46},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7327.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9026.94},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11061.07},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7327.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13157.55},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7327.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7473.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7327.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7327.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5861.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7327.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7327.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7327.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13652.44},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7327.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7236.8,"10th_percentile":7236.8,"90th_percentile":7283.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10126.0,"10th_percentile":10126.0,"90th_percentile":10126.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5816.55,"10th_percentile":4678.93,"90th_percentile":7285.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":14566.8,"10th_percentile":14566.8,"90th_percentile":14566.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7094.24,"10th_percentile":7094.24,"90th_percentile":7094.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Respiratory Infections And Inflammations With Mcc","code_information":[{"code":"177","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9385.51,"maximum":23858.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23858.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11731.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14909.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18269.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11731.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21732.5},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11731.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11966.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11731.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11731.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9385.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11731.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11731.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11731.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22549.93},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11731.89,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7851.21,"10th_percentile":7236.8,"90th_percentile":11589.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16213.01,"10th_percentile":16213.01,"90th_percentile":25652.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10505.13,"10th_percentile":10368.42,"90th_percentile":13679.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":19651.41,"10th_percentile":19651.41,"90th_percentile":19651.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3961.52,"10th_percentile":3961.52,"90th_percentile":3961.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"16","median_amount":11587.03,"10th_percentile":7899.31,"90th_percentile":11634.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11400.74,"10th_percentile":11358.77,"90th_percentile":11449.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pulmonary Embolism Without Mcc","code_information":[{"code":"176","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4834.8,"maximum":11952.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11952.04},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6043.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7469.32},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9152.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6043.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10887.19},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6043.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6164.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6043.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6043.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4834.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6043.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6043.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6043.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11296.69},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6043.5,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5984.69,"10th_percentile":5984.69,"90th_percentile":5984.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8450.44,"10th_percentile":8351.88,"90th_percentile":11103.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3180.18,"10th_percentile":3180.18,"90th_percentile":3180.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5972.32,"10th_percentile":818.59,"90th_percentile":5996.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":26697.61,"10th_percentile":26697.61,"90th_percentile":26697.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5711.71,"10th_percentile":150.0,"90th_percentile":5851.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pulmonary Embolism With Mcc Or Acute Cor Pulmonale","code_information":[{"code":"175","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8249.78,"maximum":20240.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20240.34},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10312.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12649.02},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15499.35},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10312.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18437.04},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10312.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10518.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10312.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10312.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8249.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10312.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10312.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10312.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19130.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10312.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2710.89,"10th_percentile":2710.89,"90th_percentile":2710.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4647.58,"10th_percentile":4647.58,"90th_percentile":4647.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10025.02,"10th_percentile":10025.02,"90th_percentile":10025.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10189.11,"10th_percentile":6004.32,"90th_percentile":10219.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":19747.13,"10th_percentile":19747.13,"90th_percentile":20500.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9996.07,"10th_percentile":9996.07,"90th_percentile":10006.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary Embolism","code_information":[{"code":"173","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17876.14,"maximum":43807.85,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43807.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22345.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27377.32},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33546.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22345.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39904.83},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22345.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22792.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22345.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22345.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17876.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22345.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22345.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22345.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41405.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22345.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Respiratory System O.R. Procedures Without Cc/Mcc","code_information":[{"code":"168","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8206.54,"maximum":20594.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20594.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10258.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12870.47},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15770.71},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10258.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18759.83},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10258.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10463.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10258.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10258.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8206.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10258.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10258.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10258.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19465.45},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10258.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1185.0,"10th_percentile":1185.0,"90th_percentile":1185.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10135.52,"10th_percentile":10135.52,"90th_percentile":10135.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Respiratory System O.R. Procedures With Cc","code_information":[{"code":"167","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10831.14,"maximum":27048.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27048.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13538.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16903.96},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20713.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13538.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24639.0},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13538.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13809.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13538.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13538.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10831.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13538.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13538.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13538.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25565.74},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13538.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13372.61,"10th_percentile":13372.61,"90th_percentile":13372.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24171.13,"10th_percentile":24171.13,"90th_percentile":24171.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1590.41,"10th_percentile":1590.41,"90th_percentile":1590.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":26915.75,"10th_percentile":26915.75,"90th_percentile":26915.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11606.21,"10th_percentile":11606.21,"90th_percentile":11606.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Respiratory System O.R. Procedures With Mcc","code_information":[{"code":"166","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22448.47,"maximum":57430.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57430.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28060.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35890.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43978.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28060.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52314.14},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28060.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28621.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28060.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28060.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22448.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28060.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28060.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28060.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54281.83},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28060.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13395.48,"10th_percentile":13395.48,"90th_percentile":13395.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30000.21,"10th_percentile":30000.21,"90th_percentile":30000.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":48114.63,"10th_percentile":48114.63,"90th_percentile":48114.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":11074.93,"10th_percentile":11074.93,"90th_percentile":11074.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":27743.53,"10th_percentile":27743.53,"90th_percentile":27743.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":11293.88,"10th_percentile":11293.88,"90th_percentile":11293.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Chest Procedures Without Cc/Mcc","code_information":[{"code":"165","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11496.61,"maximum":28593.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28593.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14370.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17869.48},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21896.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14370.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26046.32},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14370.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14658.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14370.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14370.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11496.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14370.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14370.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14370.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27026.0},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14370.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":26664.62,"10th_percentile":26664.62,"90th_percentile":26664.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14194.99,"10th_percentile":14194.99,"90th_percentile":14194.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":27277.35,"10th_percentile":27277.35,"90th_percentile":34440.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13295.51,"10th_percentile":13295.51,"90th_percentile":13295.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":20162.27,"10th_percentile":20162.27,"90th_percentile":20162.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14207.33,"10th_percentile":800.0,"90th_percentile":14222.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":28569.44,"10th_percentile":28569.44,"90th_percentile":28569.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13935.72,"10th_percentile":13935.72,"90th_percentile":13935.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Chest Procedures With Cc","code_information":[{"code":"164","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15159.04,"maximum":37291.39,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37291.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18948.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23304.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28556.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18948.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33968.94},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18948.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19327.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18948.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18948.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15159.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18948.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18948.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18948.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35246.61},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18948.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":35641.4,"10th_percentile":35641.4,"90th_percentile":35641.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14191.99,"10th_percentile":14191.99,"90th_percentile":14191.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17652.79,"10th_percentile":17652.79,"90th_percentile":17972.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":30135.17,"10th_percentile":30135.17,"90th_percentile":32622.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18713.1,"10th_percentile":810.0,"90th_percentile":18734.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":35273.24,"10th_percentile":35273.24,"90th_percentile":35273.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18401.18,"10th_percentile":18373.41,"90th_percentile":18402.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Chest Procedures With Mcc","code_information":[{"code":"163","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":26917.5,"maximum":66549.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66549.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33646.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41589.51},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50961.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33646.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60620.33},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33646.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34319.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33646.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33646.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26917.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33646.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33646.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33646.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62900.44},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33646.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33245.37,"10th_percentile":33245.37,"90th_percentile":33245.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":136973.1,"10th_percentile":136973.1,"90th_percentile":136973.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":44847.19,"10th_percentile":44847.19,"90th_percentile":44847.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21096.68,"10th_percentile":21096.68,"90th_percentile":21096.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32588.51,"10th_percentile":15514.54,"90th_percentile":39215.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Dental And Oral Diseases Without Cc/Mcc","code_information":[{"code":"159","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4255.22,"maximum":10215.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10215.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5319.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6384.27},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7822.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5319.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9305.63},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5319.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5425.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5319.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5319.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4255.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5319.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5319.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5319.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9655.65},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5319.03,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Dental And Oral Diseases With Cc","code_information":[{"code":"158","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5464.22,"maximum":13885.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13885.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6830.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8677.61},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10633.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6830.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12648.37},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6830.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6966.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6830.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6830.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5464.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6830.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6830.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6830.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13124.11},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6830.28,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6761.3,"10th_percentile":6761.3,"90th_percentile":6761.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Dental And Oral Diseases With Mcc","code_information":[{"code":"157","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10311.03,"maximum":26810.18,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26810.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12888.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16754.78},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20530.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12888.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24421.55},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12888.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13146.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12888.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12888.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10311.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12888.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12888.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12888.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25340.11},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12888.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12530.99,"10th_percentile":12530.99,"90th_percentile":12530.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/Mcc","code_information":[{"code":"156","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4150.72,"maximum":9868.85,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9868.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5188.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6167.45},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7557.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5188.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8989.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5188.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5292.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5188.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5188.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4150.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5188.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5188.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5188.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9327.72},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5188.4,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":8270.35,"10th_percentile":8270.35,"90th_percentile":8270.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Ear, Nose, Mouth And Throat Diagnoses With Cc","code_information":[{"code":"155","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5504.46,"maximum":13815.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13815.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6880.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8634.06},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10579.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6880.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12584.89},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6880.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7018.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6880.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6880.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5504.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6880.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6880.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6880.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13058.25},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6880.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12708.62,"10th_percentile":12708.62,"90th_percentile":12708.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":9833.61,"10th_percentile":9833.61,"90th_percentile":9833.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Ear, Nose, Mouth And Throat Diagnoses With Mcc","code_information":[{"code":"154","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9390.32,"maximum":23598.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23598.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11737.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14747.77},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18071.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11737.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21496.15},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11737.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11972.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11737.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11737.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9390.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11737.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11737.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11737.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22304.68},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11737.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11592.97,"10th_percentile":11592.97,"90th_percentile":11592.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Otitis Media And Uri Without Mcc","code_information":[{"code":"153","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4433.6,"maximum":11001.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11001.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5542.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6875.37},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8424.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5542.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10021.45},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5542.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5652.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5542.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5542.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4433.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5542.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5542.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5542.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10398.39},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5542.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":6880.78,"10th_percentile":6880.78,"90th_percentile":6880.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3190.46,"10th_percentile":3190.46,"90th_percentile":3190.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1087.99,"10th_percentile":1087.99,"90th_percentile":1087.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3190.46,"10th_percentile":3190.46,"90th_percentile":3190.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":8502.64,"10th_percentile":8502.64,"90th_percentile":8502.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Otitis Media And Uri With Mcc","code_information":[{"code":"152","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7100.25,"maximum":16527.66,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16527.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8875.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10328.81},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12656.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8875.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15055.14},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8875.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9052.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8875.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8875.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7100.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8875.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8875.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8875.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15621.41},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8875.31,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Epistaxis Without Mcc","code_information":[{"code":"151","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4408.38,"maximum":11286.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11286.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5510.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7053.28},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8642.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5510.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10280.77},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5510.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5620.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5510.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5510.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4408.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5510.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5510.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5510.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10667.46},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5510.47,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6865.53,"10th_percentile":6865.53,"90th_percentile":6865.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Epistaxis With Mcc","code_information":[{"code":"150","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7996.94,"maximum":21493.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21493.22},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9996.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13431.99},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16458.76},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9996.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19578.3},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9996.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10196.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9996.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9996.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7996.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9996.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9996.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9996.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20314.69},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9996.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Dysequilibrium","code_information":[{"code":"149","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4514.08,"maximum":11158.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11158.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5642.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6973.59},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8545.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5642.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10164.62},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5642.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5755.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5642.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5642.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4514.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5642.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5642.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5642.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10546.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5642.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3264.94,"10th_percentile":3264.94,"90th_percentile":3264.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21391.25,"10th_percentile":21391.25,"90th_percentile":21391.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5309.89,"10th_percentile":5309.89,"90th_percentile":5309.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":9214.43,"10th_percentile":9214.43,"90th_percentile":9214.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1124.01,"10th_percentile":1124.01,"90th_percentile":5574.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":713.32,"10th_percentile":713.32,"90th_percentile":713.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1100.0,"10th_percentile":130.0,"90th_percentile":5485.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ear, Nose, Mouth And Throat Malignancy Without Cc/Mcc","code_information":[{"code":"148","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4787.35,"maximum":11869.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11869.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5984.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7417.43},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9088.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5984.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10811.55},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5984.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6103.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5984.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5984.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4787.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5984.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5984.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5984.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11218.21},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5984.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ear, Nose, Mouth And Throat Malignancy With Cc","code_information":[{"code":"147","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7636.58,"maximum":19347.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19347.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9545.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12091.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14815.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9545.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17623.98},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9545.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9736.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9545.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9545.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7636.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9545.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9545.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9545.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18286.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9545.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21821.84,"10th_percentile":21821.84,"90th_percentile":21821.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ear, Nose, Mouth And Throat Malignancy With Mcc","code_information":[{"code":"146","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12717.02,"maximum":31621.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31621.54},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15896.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19761.6},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24214.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15896.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28804.25},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15896.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16214.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15896.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15896.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12717.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15896.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15896.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15896.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29887.66},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15896.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":69813.12,"10th_percentile":69813.12,"90th_percentile":69813.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16556.96,"10th_percentile":16556.96,"90th_percentile":16556.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Ear, Nose, Mouth And Throat O.R. Procedures Without Cc/Mcc","code_information":[{"code":"145","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7220.97,"maximum":18289.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18289.1},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9026.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11429.61},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14005.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9026.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16659.65},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9026.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9206.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9026.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9026.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7220.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9026.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9026.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9026.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17286.27},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9026.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14649.64,"10th_percentile":14649.64,"90th_percentile":14649.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Ear, Nose, Mouth And Throat O.R. Procedures With Cc","code_information":[{"code":"144","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10407.73,"maximum":26432.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26432.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13009.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16518.5},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20240.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13009.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24077.15},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13009.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13269.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13009.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13009.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10407.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13009.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13009.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13009.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24982.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13009.66,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17132.78,"10th_percentile":17132.78,"90th_percentile":17132.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Ear, Nose, Mouth And Throat O.R. Procedures With Mcc","code_information":[{"code":"143","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22501.93,"maximum":57083.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57083.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28127.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35674.1},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43712.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28127.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51998.1},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28127.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28689.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28127.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28127.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22501.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28127.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28127.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28127.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53953.9},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28127.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Head And Neck Procedures Without Cc/Mcc","code_information":[{"code":"142","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9587.91,"maximum":25260.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25260.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15786.48},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19343.81},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23010.17},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12224.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9587.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11984.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23875.65},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11984.89,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12881.8,"10th_percentile":12881.8,"90th_percentile":12881.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Head And Neck Procedures With Cc","code_information":[{"code":"141","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13099.6,"maximum":33136.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33136.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16374.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20708.58},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25375.05},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16374.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30184.56},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16374.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16701.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16374.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16374.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13099.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16374.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16374.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16374.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31319.89},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16374.5,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Head And Neck Procedures With Mcc","code_information":[{"code":"140","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25617.22,"maximum":63902.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63902.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32021.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39935.53},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48934.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32021.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58209.51},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32021.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32661.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32021.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32021.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25617.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32021.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32021.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32021.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60398.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32021.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":44926.4,"10th_percentile":44926.4,"90th_percentile":44926.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Salivary Gland Procedures","code_information":[{"code":"139","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7421.56,"maximum":17113.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17113.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9276.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10694.82},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13104.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9276.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15588.63},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9276.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9462.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9276.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9276.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7421.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9276.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9276.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9276.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16174.96},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9276.95,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Mouth Procedures Without Cc/Mcc","code_information":[{"code":"138","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5322.48,"maximum":13617.12,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13617.12},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8509.89},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10427.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12403.91},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6786.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5322.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6653.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12870.46},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6653.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Mouth Procedures With Cc/Mcc","code_information":[{"code":"137","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8968.1,"maximum":19926.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19926.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11210.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12452.58},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15258.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11210.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18150.71},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11210.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11434.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11210.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11210.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8968.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11210.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11210.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11210.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18833.41},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11210.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Sinus And Mastoid Procedures Without Cc/Mcc","code_information":[{"code":"136","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6097.85,"maximum":15738.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15738.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7622.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9835.86},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12052.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7622.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14336.62},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7622.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7774.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7622.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7622.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6097.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7622.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7622.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7622.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14875.86},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7622.31,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Sinus And Mastoid Procedures With Cc/Mcc","code_information":[{"code":"135","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13032.93,"maximum":32312.48,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32312.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16291.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20193.39},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24743.77},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16291.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29433.63},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16291.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16616.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16291.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16291.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13032.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16291.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16291.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16291.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30540.71},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16291.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Disorders Of The Eye Without Mcc","code_information":[{"code":"125","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4611.38,"maximum":11415.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11415.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5764.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7133.89},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8741.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5764.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10398.27},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5764.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5879.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5764.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5764.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4611.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5764.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5764.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5764.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10789.38},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5764.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2178.19,"10th_percentile":2178.19,"90th_percentile":2178.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Disorders Of The Eye With Mcc Or Thrombolytic Agent","code_information":[{"code":"124","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7946.48,"maximum":18489.27,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18489.27},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9933.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11554.7},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14158.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9933.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16841.98},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9933.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10131.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9933.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9933.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7946.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9933.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9933.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9933.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17475.46},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9933.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9854.55,"10th_percentile":9854.55,"90th_percentile":9854.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Neurological Eye Disorders","code_information":[{"code":"123","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4796.36,"maximum":12184.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12184.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5995.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7614.8},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9330.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5995.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11099.23},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5995.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6115.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5995.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5995.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4796.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5995.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5995.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5995.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11516.71},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5995.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":11277.03,"10th_percentile":11277.03,"90th_percentile":11277.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8285.48,"10th_percentile":8285.48,"90th_percentile":8285.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":830.22,"10th_percentile":830.22,"90th_percentile":830.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5804.78,"10th_percentile":5804.78,"90th_percentile":5804.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Major Eye Infections Without Cc/Mcc","code_information":[{"code":"122","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4719.48,"maximum":10976.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10976.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5899.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6859.62},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8405.37},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5899.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9998.49},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5899.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6017.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5899.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5899.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4719.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5899.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5899.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5899.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10374.56},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5899.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Major Eye Infections With Cc/Mcc","code_information":[{"code":"121","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6986.73,"maximum":18161.59,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18161.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8733.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11349.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13907.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8733.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16543.5},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8733.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8908.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8733.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8733.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6986.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8733.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8733.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8733.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17165.75},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8733.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intraocular Procedures Without Cc/Mcc","code_information":[{"code":"117","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6515.86,"maximum":15738.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15738.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8144.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9835.86},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12052.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8144.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14336.62},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8144.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8307.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8144.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8144.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6515.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8144.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8144.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8144.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14875.86},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8144.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intraocular Procedures With Cc/Mcc","code_information":[{"code":"116","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10859.38,"maximum":24127.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24127.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13574.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15078.56},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18476.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13574.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21978.31},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13574.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13845.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13574.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13574.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10859.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13574.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13574.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13574.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22804.98},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13574.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extraocular Procedures Except Orbit","code_information":[{"code":"115","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9218.54,"maximum":21929.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21929.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13704.41},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16792.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19975.37},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11753.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9218.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11523.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20726.71},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11523.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Orbital Procedures Without Cc/Mcc","code_information":[{"code":"114","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8126.06,"maximum":18759.12,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18759.12},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10157.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11723.34},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14365.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10157.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17087.79},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10157.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10360.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10157.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10157.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8126.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10157.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10157.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10157.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17730.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10157.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Orbital Procedures With Cc/Mcc","code_information":[{"code":"113","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14120.61,"maximum":31547.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31547.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17650.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19715.27},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24157.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17650.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28736.72},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17650.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18003.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17650.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17650.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14120.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17650.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17650.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17650.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29817.59},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17650.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Headaches Without Mcc","code_information":[{"code":"103","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5022.78,"maximum":12186.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12186.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6278.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7615.73},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9331.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6278.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11100.58},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6278.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6404.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6278.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6278.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5022.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6278.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6278.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6278.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11518.11},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6278.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6211.98,"10th_percentile":6211.98,"90th_percentile":6211.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22029.68,"10th_percentile":11917.28,"90th_percentile":39666.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5719.18,"10th_percentile":5719.18,"90th_percentile":5719.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":8554.19,"10th_percentile":8554.19,"90th_percentile":8554.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2670.36,"10th_percentile":2670.36,"90th_percentile":2670.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Headaches With Mcc","code_information":[{"code":"102","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6732.08,"maximum":16606.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16606.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8415.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10377.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12716.48},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8415.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15126.72},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8415.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8583.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8415.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8415.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6732.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8415.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8415.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8415.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15695.68},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8415.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Seizures Without Mcc","code_information":[{"code":"101","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5420.98,"maximum":13273.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13273.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8294.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10164.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12090.57},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6911.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5420.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6776.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12545.33},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":14586.1,"10th_percentile":14586.1,"90th_percentile":14586.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11357.92,"10th_percentile":10467.48,"90th_percentile":12162.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":1948.0,"10th_percentile":1948.0,"90th_percentile":1948.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6692.57,"10th_percentile":6692.57,"90th_percentile":6692.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6605.95,"10th_percentile":6605.95,"90th_percentile":6605.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Seizures With Mcc","code_information":[{"code":"100","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11632.34,"maximum":28521.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28521.22},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14540.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17824.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21840.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14540.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25980.14},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14540.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14831.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14540.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14540.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11632.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14540.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14540.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14540.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26957.33},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14540.43,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14391.17,"10th_percentile":14391.17,"90th_percentile":14391.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26865.2,"10th_percentile":18619.3,"90th_percentile":41378.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":22889.18,"10th_percentile":22889.18,"90th_percentile":22889.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14361.17,"10th_percentile":14361.17,"90th_percentile":14361.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14134.33,"10th_percentile":14134.33,"90th_percentile":14134.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Bacterial Infection Of Nervous System Except Viral Meningitis Without Cc/Mcc","code_information":[{"code":"099","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8182.52,"maximum":22609.69,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22609.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10228.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14129.72},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17313.71},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10228.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20595.3},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10228.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10432.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10228.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10228.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8182.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10228.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10228.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10228.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21369.95},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10228.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Cc","code_information":[{"code":"098","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13783.07,"maximum":33673.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33673.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17228.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21044.01},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25786.07},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17228.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30673.48},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17228.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17573.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17228.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17228.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13783.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17228.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17228.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17228.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31827.2},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17228.84,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":72996.57,"10th_percentile":72996.57,"90th_percentile":72996.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Mcc","code_information":[{"code":"097","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21692.32,"maximum":56651.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56651.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27115.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35403.53},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43381.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27115.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51603.72},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27115.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27657.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27115.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27115.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21692.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27115.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27115.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27115.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53544.69},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27115.4,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc","code_information":[{"code":"096","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15490.57,"maximum":34417.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34417.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21509.17},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26356.04},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31351.48},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19750.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15490.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32530.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bacterial And Tuberculous Infections Of Nervous System With Cc","code_information":[{"code":"095","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15490.57,"maximum":34839.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34839.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21772.32},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26678.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31735.05},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19750.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15490.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32928.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19363.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":172178.77,"10th_percentile":172178.77,"90th_percentile":172178.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bacterial And Tuberculous Infections Of Nervous System With Mcc","code_information":[{"code":"094","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21137.37,"maximum":50574.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50574.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26421.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31606.33},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38728.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26421.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46068.97},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26421.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26950.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26421.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26421.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21137.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26421.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26421.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26421.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47801.75},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26421.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Disorders Of Nervous System Without Cc/Mcc","code_information":[{"code":"093","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4782.54,"maximum":11539.85,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11539.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5978.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7211.73},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8836.82},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5978.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10511.72},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5978.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6097.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5978.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5978.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4782.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5978.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5978.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5978.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10907.1},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5978.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24432.1,"10th_percentile":24432.1,"90th_percentile":24432.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":2792.0,"10th_percentile":2792.0,"90th_percentile":2792.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":1274.0,"10th_percentile":1274.0,"90th_percentile":1274.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5810.06,"10th_percentile":5810.06,"90th_percentile":5810.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Disorders Of Nervous System With Cc","code_information":[{"code":"092","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6144.1,"maximum":15179.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15179.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7680.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9486.53},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11624.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7680.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13827.44},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7680.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7833.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7680.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7680.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6144.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7680.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7680.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7680.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14347.53},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7680.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10613.63,"10th_percentile":9213.63,"90th_percentile":24156.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":117195.26,"10th_percentile":117195.26,"90th_percentile":117195.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7594.19,"10th_percentile":7594.19,"90th_percentile":7594.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3077.51,"10th_percentile":3077.51,"90th_percentile":3077.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":14336.32,"10th_percentile":14336.32,"90th_percentile":14336.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7436.59,"10th_percentile":7436.59,"90th_percentile":7436.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Disorders Of Nervous System With Mcc","code_information":[{"code":"091","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10547.66,"maximum":25280.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25280.04},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13184.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15798.53},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19358.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13184.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23027.73},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13184.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13448.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13184.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13184.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10547.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13184.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13184.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13184.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23893.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13184.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9174.83,"10th_percentile":9174.83,"90th_percentile":9174.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18220.58,"10th_percentile":18220.58,"90th_percentile":51548.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":11229.55,"10th_percentile":11229.55,"90th_percentile":11229.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13020.58,"10th_percentile":8888.26,"90th_percentile":13022.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Concussion Without Cc/Mcc","code_information":[{"code":"090","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4944.1,"maximum":12276.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12276.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6180.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7672.25},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9401.11},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6180.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11182.97},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6180.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6303.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6180.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6180.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4944.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6180.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6180.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6180.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11603.59},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6180.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Concussion With Cc","code_information":[{"code":"089","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6598.14,"maximum":16785.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16785.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8247.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10490.04},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12853.86},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8247.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15290.14},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8247.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8412.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8247.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8247.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6598.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8247.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8247.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8247.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15865.25},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8247.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":275.19,"10th_percentile":275.19,"90th_percentile":275.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Concussion With Mcc","code_information":[{"code":"088","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8118.86,"maximum":21153.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21153.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10148.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13219.8},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16198.75},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10148.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19269.01},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10148.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10351.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10148.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10148.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8118.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10148.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10148.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10148.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19993.77},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10148.57,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18883.5,"10th_percentile":18883.5,"90th_percentile":18883.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Stupor And Coma <1 Hour Without Cc/Mcc","code_information":[{"code":"087","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5493.65,"maximum":13669.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13669.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6867.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8542.33},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10467.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6867.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12451.18},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6867.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7004.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6867.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6867.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5493.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6867.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6867.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6867.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12919.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6867.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6788.25,"10th_percentile":6788.25,"90th_percentile":6788.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6671.3,"10th_percentile":6671.3,"90th_percentile":6671.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Stupor And Coma <1 Hour With Cc","code_information":[{"code":"086","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7823.96,"maximum":19367.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19367.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9779.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12103.25},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14830.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9779.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17641.54},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9779.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9975.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9779.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9779.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7823.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9779.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9779.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9779.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18305.09},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9779.95,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9659.49,"10th_percentile":9659.49,"90th_percentile":9659.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Stupor And Coma <1 Hour With Mcc","code_information":[{"code":"085","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13644.94,"maximum":33277.72,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33277.72},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17056.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20796.61},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25482.92},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17056.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30312.87},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17056.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17397.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17056.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17056.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13644.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17056.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17056.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17056.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31453.02},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17056.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Stupor And Coma >1 Hour Without Cc/Mcc","code_information":[{"code":"084","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5740.5,"maximum":14235.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14235.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7175.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8896.29},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10900.98},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7175.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12967.11},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7175.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7319.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7175.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7175.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5740.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7175.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7175.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7175.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13454.84},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7175.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Stupor And Coma >1 Hour With Cc","code_information":[{"code":"083","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8383.12,"maximum":20504.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20504.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10478.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12813.95},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15701.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10478.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18677.45},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10478.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10688.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10478.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10478.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8383.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10478.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10478.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10478.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19379.96},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10478.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Stupor And Coma >1 Hour With Mcc","code_information":[{"code":"082","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13727.22,"maximum":34001.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34001.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17159.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21248.79},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26036.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17159.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30971.96},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17159.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17502.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17159.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17159.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13727.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17159.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17159.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17159.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32136.9},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17159.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":17994.47,"10th_percentile":17994.47,"90th_percentile":17994.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Nontraumatic Stupor And Coma Without Mcc","code_information":[{"code":"081","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5378.94,"maximum":11950.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11950.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6723.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7468.4},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9151.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6723.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10885.84},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6723.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6858.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6723.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6723.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5378.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6723.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6723.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6723.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11295.28},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6723.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":375.0,"10th_percentile":375.0,"90th_percentile":375.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Nontraumatic Stupor And Coma With Mcc","code_information":[{"code":"080","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10870.78,"maximum":25911.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25911.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13588.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16193.26},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19842.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13588.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23603.09},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13588.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13860.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13588.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13588.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10870.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13588.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13588.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13588.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24490.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13588.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18784.18,"10th_percentile":18784.18,"90th_percentile":18784.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Viral Meningitis Without Cc/Mcc","code_information":[{"code":"076","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4956.12,"maximum":12857.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12857.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6195.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8035.48},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9846.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6195.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11712.4},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6195.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6319.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6195.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6195.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4956.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6195.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6195.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6195.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12152.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6195.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Viral Meningitis With Cc/Mcc","code_information":[{"code":"075","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11516.42,"maximum":26242.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26242.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14395.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16399.89},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20095.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14395.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23904.27},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14395.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14683.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14395.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14395.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11516.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14395.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14395.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14395.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24803.38},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14395.53,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17267.68,"10th_percentile":17267.68,"90th_percentile":17267.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cranial And Peripheral Nerve Disorders Without Mcc","code_information":[{"code":"074","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6190.94,"maximum":15082.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15082.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7738.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9425.38},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11549.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7738.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13738.3},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7738.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7893.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7738.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7738.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6190.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7738.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7738.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7738.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14255.04},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7738.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5798.53,"10th_percentile":5798.53,"90th_percentile":5798.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10344.55,"10th_percentile":10344.55,"90th_percentile":10694.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7644.82,"10th_percentile":7644.82,"90th_percentile":7644.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":531.03,"10th_percentile":531.03,"90th_percentile":531.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3302.82,"10th_percentile":3302.82,"90th_percentile":3302.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":250.0,"10th_percentile":250.0,"90th_percentile":250.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":150.0,"10th_percentile":150.0,"90th_percentile":150.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cranial And Peripheral Nerve Disorders With Mcc","code_information":[{"code":"073","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9635.36,"maximum":23386.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23386.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12044.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14615.26},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17908.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12044.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21303.01},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12044.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12285.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12044.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12044.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9635.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12044.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12044.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12044.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22104.28},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12044.2,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":14555.93,"10th_percentile":14555.93,"90th_percentile":14555.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16644.61,"10th_percentile":16644.61,"90th_percentile":16644.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":4738.08,"10th_percentile":4738.08,"90th_percentile":4738.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1404.16,"10th_percentile":1404.16,"90th_percentile":1404.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Cerebrovascular Disorders Without Cc/Mcc","code_information":[{"code":"072","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4541.7,"maximum":10888.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10888.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5677.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6804.95},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8338.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5677.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9918.81},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5677.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5790.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5677.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5677.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4541.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5677.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5677.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5677.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10291.88},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5677.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14787.0,"10th_percentile":14787.0,"90th_percentile":14787.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Cerebrovascular Disorders With Cc","code_information":[{"code":"071","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6162.11,"maximum":15083.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15083.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7702.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9426.3},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11550.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7702.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13739.65},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7702.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7856.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7702.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7702.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6162.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7702.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7702.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7702.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14256.44},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7702.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"1 through 10","median_amount":7505.19,"10th_percentile":7505.19,"90th_percentile":7505.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7168.12,"10th_percentile":7168.12,"90th_percentile":7168.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7610.84,"10th_percentile":7610.84,"90th_percentile":7610.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7458.39,"10th_percentile":7458.39,"90th_percentile":7458.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Cerebrovascular Disorders With Mcc","code_information":[{"code":"070","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9998.72,"maximum":23855.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23855.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12498.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14908.07},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18267.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12498.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21729.8},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12498.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12748.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12498.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12498.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9998.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12498.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12498.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12498.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22547.12},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12498.4,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23473.4,"10th_percentile":23473.4,"90th_percentile":23473.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12370.94,"10th_percentile":12356.09,"90th_percentile":25457.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12103.06,"10th_percentile":12103.06,"90th_percentile":12103.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Transient Ischemia Without Thrombolytic","code_information":[{"code":"069","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4797.56,"maximum":11805.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11805.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5996.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7377.59},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9040.05},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5996.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10753.48},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5996.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6116.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5996.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5996.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4797.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5996.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5996.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5996.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11157.95},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5996.95,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5922.35,"10th_percentile":5922.35,"90th_percentile":5922.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15058.18,"10th_percentile":15058.18,"90th_percentile":15058.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5444.92,"10th_percentile":5444.92,"90th_percentile":5444.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":2792.0,"10th_percentile":2792.0,"90th_percentile":2792.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5923.71,"10th_percentile":1043.12,"90th_percentile":5927.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1050.44,"10th_percentile":1050.44,"90th_percentile":1050.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10237.74,"10th_percentile":10237.74,"90th_percentile":10237.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":13759.0,"10th_percentile":13759.0,"90th_percentile":13759.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":280.59,"10th_percentile":280.59,"90th_percentile":280.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Precerebral Occlusion Without Infarction Without Mcc","code_information":[{"code":"068","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5191.55,"maximum":13360.61,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13360.61},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6489.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8349.59},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10231.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6489.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12170.26},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6489.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6619.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6489.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6489.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5191.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6489.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6489.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6489.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12628.02},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6489.44,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":248.97,"10th_percentile":248.97,"90th_percentile":248.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1457.69,"10th_percentile":1457.69,"90th_percentile":1457.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Precerebral Occlusion Without Infarction With Mcc","code_information":[{"code":"067","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8820.95,"maximum":21178.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21178.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11026.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13235.55},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16218.05},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11026.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19291.97},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11026.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11246.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11026.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11026.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8820.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11026.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11026.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11026.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20017.6},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11026.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4967.14,"10th_percentile":4967.14,"90th_percentile":4967.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc","code_information":[{"code":"066","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4110.48,"maximum":10037.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10037.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5138.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6273.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7686.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5138.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9143.56},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5138.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5240.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5138.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5138.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4110.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5138.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5138.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5138.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9487.48},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5138.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":10147.6,"10th_percentile":10147.6,"90th_percentile":10147.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5074.66,"10th_percentile":5074.18,"90th_percentile":5081.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12401.62,"10th_percentile":12401.62,"90th_percentile":12401.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4974.32,"10th_percentile":1400.0,"90th_percentile":5102.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":3707.31,"10th_percentile":3707.31,"90th_percentile":3707.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4989.69,"10th_percentile":4989.69,"90th_percentile":4989.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours","code_information":[{"code":"065","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6067.82,"maximum":14690.59,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14690.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7584.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9180.75},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11249.54},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7584.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13381.74},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7584.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7736.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7584.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7584.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6067.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7584.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7584.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7584.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13885.07},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7584.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5350.41,"10th_percentile":5350.41,"90th_percentile":7491.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19045.17,"10th_percentile":19045.17,"90th_percentile":19045.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7374.22,"10th_percentile":7374.22,"90th_percentile":7374.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":10088.21,"10th_percentile":10088.21,"90th_percentile":10088.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"13","median_amount":7502.42,"10th_percentile":7338.46,"90th_percentile":7522.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2988.03,"10th_percentile":2988.03,"90th_percentile":2988.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":14158.34,"10th_percentile":14158.34,"90th_percentile":14339.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7388.25,"10th_percentile":7201.61,"90th_percentile":7398.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intracranial Hemorrhage Or Cerebral Infarction With Mcc","code_information":[{"code":"064","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12077.98,"maximum":29231.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29231.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15097.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18267.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22384.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15097.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26627.08},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15097.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15399.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15097.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15097.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12077.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15097.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15097.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15097.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27628.6},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15097.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13806.82,"10th_percentile":13806.82,"90th_percentile":14968.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22707.19,"10th_percentile":22707.19,"90th_percentile":27069.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6179.61,"10th_percentile":6179.61,"90th_percentile":6179.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":25323.9,"10th_percentile":25323.9,"90th_percentile":25323.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"13","median_amount":13555.66,"10th_percentile":6783.45,"90th_percentile":14912.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14650.33,"10th_percentile":14650.33,"90th_percentile":14650.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent Without Cc/Mcc","code_information":[{"code":"063","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8431.17,"maximum":21579.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21579.22},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10538.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13485.74},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16524.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10538.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19656.63},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10538.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10749.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10538.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10538.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8431.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10538.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10538.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10538.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20395.98},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10538.96,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Cc","code_information":[{"code":"062","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10553.67,"maximum":26365.37,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26365.37},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13192.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16476.8},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20189.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13192.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24016.37},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13192.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13455.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13192.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13192.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10553.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13192.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13192.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13192.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24919.69},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13192.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10317.09,"10th_percentile":10317.09,"90th_percentile":10317.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":15089.84,"10th_percentile":15089.84,"90th_percentile":15089.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10419.86,"10th_percentile":10419.86,"90th_percentile":10419.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Mcc","code_information":[{"code":"061","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16559.03,"maximum":40345.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40345.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20698.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25213.71},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30895.37},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20698.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36751.18},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20698.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21112.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20698.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20698.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16559.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20698.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20698.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20698.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38133.5},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20698.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":117308.0,"10th_percentile":117308.0,"90th_percentile":117308.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20443.71,"10th_percentile":20443.71,"90th_percentile":20465.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20077.51,"10th_percentile":20077.51,"90th_percentile":20077.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Sclerosis And Cerebellar Ataxia Without Cc/Mcc","code_information":[{"code":"060","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5524.28,"maximum":13712.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13712.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6905.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8569.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10500.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6905.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12490.35},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6905.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7043.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6905.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6905.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5524.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6905.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6905.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6905.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12960.15},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6905.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":11888.42,"10th_percentile":11888.42,"90th_percentile":11888.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Sclerosis And Cerebellar Ataxia With Cc","code_information":[{"code":"059","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7452.79,"maximum":17787.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17787.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9315.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11116.42},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13621.39},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9315.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16203.15},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9315.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9502.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9315.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9315.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7452.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9315.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9315.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9315.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16812.6},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9315.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Sclerosis And Cerebellar Ataxia With Mcc","code_information":[{"code":"058","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10267.18,"maximum":27326.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27326.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12833.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17077.24},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20925.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12833.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24891.56},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12833.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13090.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12833.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12833.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10267.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12833.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12833.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12833.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25827.8},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12833.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Degenerative Nervous System Disorders Without Mcc","code_information":[{"code":"057","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7781.32,"maximum":19030.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19030.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9726.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11892.91},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14572.86},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9726.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17334.95},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9726.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9921.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9726.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9726.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7781.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9726.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9726.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9726.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17986.97},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9726.65,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":7600.19,"10th_percentile":7600.19,"90th_percentile":7600.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2710.89,"10th_percentile":2710.89,"90th_percentile":2710.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18212.3,"10th_percentile":18212.3,"90th_percentile":18212.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":8646.55,"10th_percentile":8646.55,"90th_percentile":8646.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9620.57,"10th_percentile":9620.57,"90th_percentile":26238.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":214.68,"10th_percentile":214.68,"90th_percentile":214.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12901.79,"10th_percentile":12901.79,"90th_percentile":12901.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Degenerative Nervous System Disorders With Mcc","code_information":[{"code":"056","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13952.44,"maximum":33581.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33581.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17440.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20986.56},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25715.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17440.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30589.74},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17440.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17789.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17440.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17440.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13952.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17440.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17440.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17440.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31740.31},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17440.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16954.8,"10th_percentile":16954.8,"90th_percentile":16954.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17261.1,"10th_percentile":17261.1,"90th_percentile":17261.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Nervous System Neoplasms Without Mcc","code_information":[{"code":"055","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6123.67,"maximum":15258.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15258.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7654.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9535.64},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11684.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7654.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13899.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7654.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7807.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7654.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7654.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6123.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7654.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7654.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7654.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14421.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7654.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7890.22,"10th_percentile":7890.22,"90th_percentile":7890.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":550.0,"10th_percentile":550.0,"90th_percentile":550.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Nervous System Neoplasms With Mcc","code_information":[{"code":"054","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9170.5,"maximum":22532.59,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22532.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11463.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14081.54},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17254.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11463.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20525.07},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11463.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11692.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11463.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11463.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9170.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11463.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11463.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11463.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21297.08},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11463.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8497.4,"10th_percentile":8497.4,"90th_percentile":8497.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21758.33,"10th_percentile":9988.86,"90th_percentile":70600.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10918.86,"10th_percentile":10918.86,"90th_percentile":10918.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11320.53,"10th_percentile":11320.53,"90th_percentile":11369.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":14288.67,"10th_percentile":14288.67,"90th_percentile":14288.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5560.28,"10th_percentile":5560.28,"90th_percentile":5560.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Disorders And Injuries Without Cc/Mcc","code_information":[{"code":"053","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5881.03,"maximum":14416.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14416.29},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7351.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9009.33},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11039.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7351.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13131.88},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7351.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7498.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7351.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7351.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5881.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7351.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7351.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7351.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13625.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7351.29,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Disorders And Injuries With Cc/Mcc","code_information":[{"code":"052","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10878.59,"maximum":26455.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26455.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13598.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16533.32},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20258.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13598.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24098.76},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13598.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13870.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13598.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13598.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10878.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13598.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13598.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13598.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25005.18},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13598.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc","code_information":[{"code":"042","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10376.5,"maximum":24845.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24845.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12970.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15527.04},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19025.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12970.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22632.0},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12970.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13230.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12970.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12970.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10376.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12970.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12970.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12970.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23483.26},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12970.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12163.74,"10th_percentile":12163.74,"90th_percentile":12163.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":25785.92,"10th_percentile":25785.92,"90th_percentile":25785.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Peripheral Neurostimulator","code_information":[{"code":"041","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13205.3,"maximum":32315.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32315.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16506.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20195.25},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24746.04},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16506.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29436.33},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16506.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16836.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16506.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16506.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13205.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16506.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16506.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16506.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30543.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16506.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30834.01,"10th_percentile":30834.01,"90th_percentile":30834.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15726.9,"10th_percentile":15726.9,"90th_percentile":15726.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16333.31,"10th_percentile":16333.31,"90th_percentile":16333.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16036.68,"10th_percentile":16036.68,"90th_percentile":16036.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc","code_information":[{"code":"040","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23190.21,"maximum":55108.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55108.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28987.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34439.87},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42200.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28987.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50199.1},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28987.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29567.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28987.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28987.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23190.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28987.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28987.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28987.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52087.24},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28987.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":339.12,"10th_percentile":339.12,"90th_percentile":339.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extracranial Procedures Without Cc/Mcc","code_information":[{"code":"039","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7060.01,"maximum":17581.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17581.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8825.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10987.62},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13463.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8825.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16015.41},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8825.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9001.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8825.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8825.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7060.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8825.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8825.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8825.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16617.8},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8825.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8723.95,"10th_percentile":8723.95,"90th_percentile":8723.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8009.32,"10th_percentile":8009.32,"90th_percentile":8009.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8719.23,"10th_percentile":8715.63,"90th_percentile":8722.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extracranial Procedures With Cc","code_information":[{"code":"038","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9745.27,"maximum":24175.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24175.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12181.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15108.21},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18512.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12181.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22021.53},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12181.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12425.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12181.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12181.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9745.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12181.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12181.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12181.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22849.83},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12181.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extracranial Procedures With Mcc","code_information":[{"code":"037","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19772.22,"maximum":50754.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50754.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24715.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31718.44},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38865.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24715.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46232.39},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24715.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25209.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24715.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24715.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19772.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24715.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24715.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24715.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47971.32},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24715.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Carotid Artery Stent Procedures Without Cc/Mcc","code_information":[{"code":"036","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11668.38,"maximum":28461.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28461.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14585.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17787.01},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21795.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14585.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25926.12},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14585.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14877.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14585.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14585.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11668.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14585.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14585.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14585.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26901.27},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14585.47,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14409.85,"10th_percentile":14409.85,"90th_percentile":14409.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":28996.29,"10th_percentile":28996.29,"90th_percentile":28996.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Carotid Artery Stent Procedures With Cc","code_information":[{"code":"035","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14357.25,"maximum":35663.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35663.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17946.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22287.51},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27309.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17946.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32485.98},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17946.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18305.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17946.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17946.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14357.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17946.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17946.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17946.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33707.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17946.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14421.2,"10th_percentile":14421.2,"90th_percentile":14421.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14404.05,"10th_percentile":14404.05,"90th_percentile":14404.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Carotid Artery Stent Procedures With Mcc","code_information":[{"code":"034","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23247.26,"maximum":57700.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57700.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29059.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36059.57},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44185.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29059.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52559.95},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29059.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29640.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29059.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29059.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23247.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29059.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29059.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29059.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54536.88},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29059.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28134.92,"10th_percentile":28134.92,"90th_percentile":28134.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ventricular Shunt Procedures Without Cc/Mcc","code_information":[{"code":"033","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9987.31,"maximum":25641.81,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25641.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12484.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16024.62},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19635.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12484.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23357.28},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12484.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12733.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12484.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12484.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9987.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12484.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12484.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12484.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24235.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12484.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ventricular Shunt Procedures With Cc","code_information":[{"code":"032","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12798.7,"maximum":30282.66,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30282.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15998.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18924.88},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23189.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15998.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27584.65},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15998.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16318.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15998.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15998.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12798.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15998.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15998.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15998.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28622.19},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15998.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12328.84,"10th_percentile":12328.84,"90th_percentile":12328.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ventricular Shunt Procedures With Mcc","code_information":[{"code":"031","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":26909.7,"maximum":63158.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63158.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33637.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39470.38},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48364.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33637.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57531.51},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33637.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34309.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33637.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33637.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":26909.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33637.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33637.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33637.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59695.44},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":33637.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Procedures Without Cc/Mcc","code_information":[{"code":"030","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13184.28,"maximum":33452.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33452.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16480.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20905.95},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25616.89},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16480.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30472.24},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16480.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16809.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16480.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16480.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13184.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16480.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16480.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16480.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31618.39},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16480.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13852.49,"10th_percentile":13852.49,"90th_percentile":13852.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16291.89,"10th_percentile":16291.89,"90th_percentile":16291.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Procedures With Cc Or Spinal Neurostimulators","code_information":[{"code":"029","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20489.93,"maximum":52145.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52145.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25612.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32587.6},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39930.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25612.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47499.25},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25612.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26124.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25612.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25612.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20489.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25612.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25612.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25612.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49285.84},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25612.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25296.2,"10th_percentile":25296.2,"90th_percentile":25296.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":48615.3,"10th_percentile":48615.3,"90th_percentile":48615.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25295.82,"10th_percentile":25295.82,"90th_percentile":25295.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24810.23,"10th_percentile":24810.23,"90th_percentile":24810.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Procedures With Mcc","code_information":[{"code":"028","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36085.6,"maximum":91184.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":91184.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45107.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":56984.97},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69825.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45107.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":83060.55},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45107.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46009.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45107.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45107.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36085.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45107.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45107.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45107.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":86184.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45107.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":51897.94,"10th_percentile":51897.94,"90th_percentile":51897.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc","code_information":[{"code":"027","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15152.43,"maximum":39043.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39043.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18940.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24400.16},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29898.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18940.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35565.35},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18940.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19319.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18940.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18940.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15152.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18940.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18940.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18940.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36903.07},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18940.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":35351.33,"10th_percentile":35351.33,"90th_percentile":35351.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":600.0,"10th_percentile":600.0,"90th_percentile":600.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1883.18,"10th_percentile":1883.18,"90th_percentile":1883.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Craniotomy And Endovascular Intracranial Procedures With Cc","code_information":[{"code":"026","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18673.73,"maximum":47309.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47309.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23342.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29565.95},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36228.34},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23342.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43094.94},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23342.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23809.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23342.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23342.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18673.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23342.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23342.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23342.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44715.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23342.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":60323.65,"10th_percentile":60323.65,"90th_percentile":60323.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18716.94,"10th_percentile":18716.94,"90th_percentile":18716.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Craniotomy And Endovascular Intracranial Procedures With Mcc","code_information":[{"code":"025","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27307.3,"maximum":68371.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":68371.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34134.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42728.31},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52356.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34134.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62280.22},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34134.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34816.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34134.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34134.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27307.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34134.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34134.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34134.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64622.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34134.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33735.8,"10th_percentile":33735.8,"90th_percentile":33735.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":64790.48,"10th_percentile":59124.2,"90th_percentile":91644.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33729.52,"10th_percentile":33729.52,"90th_percentile":33751.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Without Mcc","code_information":[{"code":"024","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23494.71,"maximum":58848.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58848.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29368.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36776.75},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45064.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29368.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53605.31},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29368.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29955.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29368.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29368.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23494.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29368.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29368.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29368.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55621.57},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29368.39,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":27590.44,"10th_percentile":27590.44,"90th_percentile":27590.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30709.12,"10th_percentile":30709.12,"90th_percentile":30709.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28444.08,"10th_percentile":28444.08,"90th_percentile":28444.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis With Mcc Or Antineopla","code_information":[{"code":"023","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":34415.94,"maximum":85139.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":85139.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43019.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":53207.23},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65196.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43019.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77554.15},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43019.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43880.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43019.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43019.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34415.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43019.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43019.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43019.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":80471.19},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43019.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":66904.72,"10th_percentile":66904.72,"90th_percentile":66904.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":42487.21,"10th_percentile":42487.21,"90th_percentile":42487.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/Mcc","code_information":[{"code":"022","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19083.34,"maximum":49698.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49698.62},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23854.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31058.71},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38057.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23854.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45270.76},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23854.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24331.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23854.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23854.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19083.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23854.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23854.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23854.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46973.53},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23854.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5074.66,"10th_percentile":5074.66,"90th_percentile":5074.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc","code_information":[{"code":"021","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31794.34,"maximum":81108.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81108.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39742.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":50687.8},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62109.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39742.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73881.87},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39742.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40537.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39742.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39742.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31794.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39742.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39742.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39742.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":76660.78},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39742.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":61861.59,"10th_percentile":61861.59,"90th_percentile":61861.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":79009.97,"10th_percentile":79009.97,"90th_percentile":79009.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc","code_information":[{"code":"020","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":47259.69,"maximum":118014.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":118014.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59074.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":73751.8},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":90371.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59074.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":107499.66},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59074.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":60256.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59074.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59074.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":47259.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":59074.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59074.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59074.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":111543.03},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":59074.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":58339.77,"10th_percentile":58339.77,"90th_percentile":58339.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":84276.42,"10th_percentile":84276.42,"90th_percentile":84276.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":58369.77,"10th_percentile":58369.77,"90th_percentile":58369.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Simultaneous Pancreas, Islet Cell And Kidney Transplant With Hemodialysis","code_information":[{"code":"019","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":42850.11,"maximum":111886.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":111886.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53562.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":69922.16},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":85678.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53562.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":101917.63},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53562.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54633.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53562.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53562.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":42850.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":53562.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53562.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53562.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":105751.05},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53562.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Autologous Bone Marrow Transplant Without Cc/Mcc","code_information":[{"code":"017","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32626.17,"maximum":72490.69,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72490.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40782.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45302.4},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55510.84},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40782.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66032.18},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40782.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41598.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40782.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40782.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32626.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40782.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40782.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40782.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":68515.85},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40782.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc","code_information":[{"code":"013","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17307.97,"maximum":40471.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40471.78},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21634.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25292.47},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30991.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21634.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36865.98},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21634.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22067.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21634.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21634.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17307.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21634.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21634.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21634.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38252.61},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21634.96,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc","code_information":[{"code":"012","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25321.12,"maximum":64928.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64928.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31651.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40576.74},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49720.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31651.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59144.12},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31651.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32284.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31651.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31651.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25321.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31651.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31651.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31651.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61368.71},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31651.4,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc","code_information":[{"code":"011","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32757.1,"maximum":83222.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":83222.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40946.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":52009.13},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63728.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40946.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":75807.83},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40946.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41765.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40946.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40946.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32757.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40946.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40946.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40946.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":78659.18},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40946.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":64158.16,"10th_percentile":64158.16,"90th_percentile":64158.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pancreas Or Islet Cell Transplant","code_information":[{"code":"010","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":43096.96,"maximum":111539.07,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":111539.07},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53871.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":69705.34},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":85412.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53871.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":101601.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53871.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54948.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53871.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53871.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43096.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":53871.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53871.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53871.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":105423.12},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53871.2,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Simultaneous Pancreas, Islet Cell And Kidney Transplant","code_information":[{"code":"008","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":33661.0,"maximum":81729.39,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81729.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42076.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51076.05},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62585.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42076.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74447.77},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42076.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42917.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42076.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42076.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33661.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42076.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42076.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42076.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77247.97},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42076.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lung Transplant","code_information":[{"code":"007","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":77778.37,"maximum":220483.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":220483.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":97222.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":137789.13},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":168838.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":97222.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":200839.62},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":97222.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":99167.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":97222.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":97222.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":77778.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":97222.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":97222.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":97222.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":208393.79},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":97222.96,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Liver Transplant Without Mcc","code_information":[{"code":"006","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27849.63,"maximum":67840.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67840.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34812.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42396.58},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51950.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34812.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":61796.7},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34812.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35508.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34812.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34812.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27849.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34812.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34812.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34812.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64121.06},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34812.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Liver Transplant With Mcc Or Intestinal Transplant","code_information":[{"code":"005","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":61924.44,"maximum":155299.48,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":155299.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":77405.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":97053.01},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":118922.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":77405.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":141463.19},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":77405.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":78953.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":77405.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":77405.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":61924.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":77405.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":77405.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":77405.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":146784.04},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":77405.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck Without Major O.R.","code_information":[{"code":"004","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":83190.94,"maximum":201461.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":201461.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":103988.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":125901.78},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":154272.48},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":103988.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":183512.78},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":103988.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":106068.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":103988.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":103988.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":83190.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":103988.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":103988.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":103988.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":190415.23},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":103988.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":146239.38,"10th_percentile":146239.38,"90th_percentile":146239.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":102704.82,"10th_percentile":102704.82,"90th_percentile":102704.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":108736.05,"10th_percentile":108736.05,"90th_percentile":108736.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck With Major","code_information":[{"code":"003","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":127477.67,"maximum":315428.12,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":315428.12},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":159347.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":197123.96},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":241543.86},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":159347.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":287325.29},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":159347.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":162534.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":159347.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":159347.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":127477.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":159347.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":159347.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":159347.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":298132.43},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":159347.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":174946.99,"10th_percentile":174946.99,"90th_percentile":174946.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Heart Transplant Or Implant Of Heart Assist System Without Mcc","code_information":[{"code":"002","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":68058.32,"maximum":163154.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":163154.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":85072.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":101962.14},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":124938.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":85072.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":148618.67},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":85072.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":86774.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":85072.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":85072.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":68058.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":85072.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":85072.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":85072.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":154208.65},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":85072.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Heart Transplant Or Implant Of Heart Assist System With Mcc","code_information":[{"code":"001","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":168310.38,"maximum":416383.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":416383.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":210387.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":260215.22},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":318852.11},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":210387.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":379286.3},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":210387.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":214595.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":210387.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":210387.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":168310.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":210387.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":210387.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":210387.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":393552.36},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":210387.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":207815.01,"10th_percentile":207815.01,"90th_percentile":207815.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cholecystectomy With C.D.E. With Mcc","code_information":[{"code":"411","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19839.48,"maximum":44080.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44080.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24799.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27547.82},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33755.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24799.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40153.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24799.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25295.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24799.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24799.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19839.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24799.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24799.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24799.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41663.62},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24799.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cholecystectomy With C.D.E. With Cc","code_information":[{"code":"412","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12627.53,"maximum":31913.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31913.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15784.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19944.14},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24438.35},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15784.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29070.31},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15784.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16100.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15784.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15784.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12627.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15784.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15784.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15784.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30163.73},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15784.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cholecystectomy With C.D.E. Without Cc/Mcc","code_information":[{"code":"413","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9972.9,"maximum":27123.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27123.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12466.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16950.29},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20769.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12466.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24706.53},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12466.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12715.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12466.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12466.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9972.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12466.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12466.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12466.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25635.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12466.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cholecystectomy Except By Laparoscope Without C.D.E. With Mcc","code_information":[{"code":"414","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21396.83,"maximum":54008.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54008.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26746.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33752.33},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41358.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26746.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49196.96},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26746.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27280.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26746.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26746.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21396.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26746.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26746.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26746.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51047.4},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26746.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cholecystectomy Except By Laparoscope Without C.D.E. With Cc","code_information":[{"code":"415","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12412.51,"maximum":29768.17,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29768.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15515.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18603.35},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22795.43},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15515.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27116.0},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15515.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15825.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15515.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15515.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12412.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15515.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15515.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15515.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28135.91},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15515.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cholecystectomy Except By Laparoscope Without C.D.E. Without Cc/Mcc","code_information":[{"code":"416","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8187.92,"maximum":20922.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20922.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10234.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13075.25},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16021.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10234.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19058.32},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10234.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10439.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10234.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10234.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8187.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10234.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10234.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10234.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19775.16},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10234.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Laparoscopic Cholecystectomy Without C.D.E. With Mcc","code_information":[{"code":"417","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14332.62,"maximum":35598.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35598.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17915.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22246.74},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27259.82},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17915.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32426.56},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17915.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18274.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17915.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17915.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14332.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17915.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17915.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17915.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33646.21},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17915.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17910.92,"10th_percentile":17910.92,"90th_percentile":17910.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17708.59,"10th_percentile":17694.59,"90th_percentile":17710.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17348.14,"10th_percentile":17348.14,"90th_percentile":17348.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Laparoscopic Cholecystectomy Without C.D.E. With Cc","code_information":[{"code":"418","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10159.68,"maximum":25745.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25745.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12699.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16089.48},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19715.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12699.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23451.82},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12699.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12953.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12699.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12699.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10159.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12699.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12699.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12699.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24333.91},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12699.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12574.18,"10th_percentile":12574.18,"90th_percentile":12574.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11638.9,"10th_percentile":11638.9,"90th_percentile":11638.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":21863.93,"10th_percentile":21863.93,"90th_percentile":21863.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5622.09,"10th_percentile":5622.09,"90th_percentile":5622.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12565.62,"10th_percentile":12565.62,"90th_percentile":12565.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5622.09,"10th_percentile":5622.09,"90th_percentile":5622.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5622.09,"10th_percentile":5622.09,"90th_percentile":5622.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12311.51,"10th_percentile":12311.51,"90th_percentile":12311.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Laparoscopic Cholecystectomy Without C.D.E. Without Cc/Mcc","code_information":[{"code":"419","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8202.94,"maximum":20913.48,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20913.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10253.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13069.69},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16014.82},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10253.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19050.21},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10253.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10458.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10253.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10253.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8202.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10253.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10253.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10253.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19766.75},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10253.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":19286.46,"10th_percentile":19286.46,"90th_percentile":19286.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10142.88,"10th_percentile":10142.88,"90th_percentile":10142.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17516.39,"10th_percentile":12557.69,"90th_percentile":64174.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9743.1,"10th_percentile":9743.1,"90th_percentile":9743.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":14358.54,"10th_percentile":2000.0,"90th_percentile":15344.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10140.12,"10th_percentile":10140.12,"90th_percentile":10144.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":1227.0,"10th_percentile":350.0,"90th_percentile":20384.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9942.38,"10th_percentile":275.19,"90th_percentile":9972.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hepatobiliary Diagnostic Procedures With Mcc","code_information":[{"code":"420","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20462.9,"maximum":45465.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45465.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25578.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28413.26},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34815.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25578.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41414.8},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25578.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26090.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25578.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25578.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20462.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25578.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25578.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25578.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42972.53},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25578.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":723998.56,"10th_percentile":723998.56,"90th_percentile":742180.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hepatobiliary Diagnostic Procedures With Cc","code_information":[{"code":"421","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10435.35,"maximum":25406.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25406.06},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13044.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15877.29},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19455.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13044.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23142.53},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13044.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13305.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13044.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13044.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10435.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13044.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13044.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13044.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24012.99},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13044.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10403.98,"10th_percentile":10403.98,"90th_percentile":10403.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Hepatobiliary Or Pancreas O.R. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Hepatobiliary Or Pancreas O.R. Procedures With Cc","code_information":[{"code":"424","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13140.44,"maximum":32005.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32005.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16425.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20001.59},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24508.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16425.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29154.05},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16425.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16754.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16425.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16425.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13140.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16425.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16425.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16425.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30250.62},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16425.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16222.74,"10th_percentile":16222.74,"90th_percentile":16222.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Hepatobiliary Or Pancreas O.R. Procedures Without Cc/Mcc","code_information":[{"code":"425","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9010.74,"maximum":27902.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27902.93},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11263.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17437.69},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21367.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11263.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25416.94},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11263.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11488.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11263.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11263.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9010.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11263.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11263.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11263.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26372.95},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11263.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical With Mcc","code_information":[{"code":"426","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":66192.87,"maximum":147070.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":147070.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":82741.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":91910.38},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":112621.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":82741.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":133967.36},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":82741.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":84395.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":82741.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":82741.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":66192.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":82741.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":82741.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":82741.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":139006.27},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":82741.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":71677.8,"10th_percentile":71677.8,"90th_percentile":71677.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical With Cc","code_information":[{"code":"427","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":43354.62,"maximum":99375.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":99375.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54193.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":62103.51},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":76097.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54193.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":90521.26},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54193.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":55277.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54193.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54193.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43354.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":54193.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54193.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54193.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":93926.03},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54193.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":73732.77,"10th_percentile":73732.77,"90th_percentile":73732.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":127675.92,"10th_percentile":127675.92,"90th_percentile":127675.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":53544.2,"10th_percentile":53544.2,"90th_percentile":53544.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Without Cc/Mcc","code_information":[{"code":"428","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":33765.5,"maximum":87775.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":87775.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42206.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":54854.72},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67215.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42206.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79955.52},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42206.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43051.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42206.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42206.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33765.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42206.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42206.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42206.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":82962.88},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42206.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":69284.36,"10th_percentile":69284.36,"90th_percentile":69284.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":77134.46,"10th_percentile":77134.46,"90th_percentile":77134.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":42012.23,"10th_percentile":42012.23,"90th_percentile":42012.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Combined Anterior And Posterior Cervical Spinal Fusion With Mcc","code_information":[{"code":"429","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":54111.29,"maximum":131089.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":131089.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":67639.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":81923.49},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":100384.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":67639.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":119410.6},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":67639.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":68991.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":67639.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":67639.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":54111.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":67639.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":67639.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":67639.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":123901.98},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":67639.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc","code_information":[{"code":"430","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":34636.97,"maximum":87391.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":87391.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43296.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":54614.73},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66921.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43296.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79605.71},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43296.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44162.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43296.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43296.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34636.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43296.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43296.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43296.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":82599.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43296.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":84346.27,"10th_percentile":84346.27,"90th_percentile":84346.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cirrhosis And Alcoholic Hepatitis With Mcc","code_information":[{"code":"432","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11820.93,"maximum":29398.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29398.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14776.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18372.62},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22512.71},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14776.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26779.7},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14776.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15071.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14776.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14776.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11820.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14776.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14776.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14776.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27786.96},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14776.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":14914.6,"10th_percentile":14914.6,"90th_percentile":14914.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28046.85,"10th_percentile":28046.85,"90th_percentile":28046.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13916.53,"10th_percentile":13916.53,"90th_percentile":13916.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":12132.07,"10th_percentile":12132.07,"90th_percentile":12132.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14593.55,"10th_percentile":14593.55,"90th_percentile":14593.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":27454.83,"10th_percentile":27454.83,"90th_percentile":27454.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cirrhosis And Alcoholic Hepatitis With Cc","code_information":[{"code":"433","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6343.5,"maximum":15420.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15420.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7929.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9636.64},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11808.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7929.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14046.24},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7929.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8087.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7929.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7929.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6343.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7929.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7929.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7929.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14574.56},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7929.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12671.95,"10th_percentile":9050.85,"90th_percentile":19910.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":11022.27,"10th_percentile":11022.27,"90th_percentile":12896.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":363.07,"10th_percentile":363.07,"90th_percentile":363.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3158.0,"10th_percentile":3158.0,"90th_percentile":3158.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":14801.59,"10th_percentile":14801.59,"90th_percentile":15763.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cirrhosis And Alcoholic Hepatitis Without Cc/Mcc","code_information":[{"code":"434","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4279.25,"maximum":9508.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9508.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5349.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5942.29},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7281.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5349.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8661.4},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5349.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5456.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5349.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5349.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4279.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5349.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5349.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5349.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8987.18},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5349.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy Of Hepatobiliary System Or Pancreas With Mcc","code_information":[{"code":"435","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11031.14,"maximum":27323.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27323.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13788.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17075.38},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20923.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13788.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24888.86},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13788.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14064.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13788.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13788.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11031.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13788.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13788.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13788.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25825.0},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13788.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13617.42,"10th_percentile":13617.42,"90th_percentile":13617.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26172.98,"10th_percentile":26172.98,"90th_percentile":26172.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13629.42,"10th_percentile":13629.42,"90th_percentile":13632.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":272.39,"10th_percentile":272.39,"90th_percentile":272.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy Of Hepatobiliary System Or Pancreas With Cc","code_information":[{"code":"436","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6793.34,"maximum":16638.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16638.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8491.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10398.31},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12741.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8491.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15156.43},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8491.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8661.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8491.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8491.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6793.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8491.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8491.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8491.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15726.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8491.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":15972.26,"10th_percentile":15972.26,"90th_percentile":15972.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8136.72,"10th_percentile":8136.72,"90th_percentile":8136.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9939.76,"10th_percentile":9939.76,"90th_percentile":9939.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7100.17,"10th_percentile":7100.17,"90th_percentile":7100.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":11913.88,"10th_percentile":11913.88,"90th_percentile":11913.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8407.05,"10th_percentile":8407.05,"90th_percentile":8413.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy Of Hepatobiliary System Or Pancreas Without Cc/Mcc","code_information":[{"code":"437","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5124.89,"maximum":11977.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11977.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6406.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7485.07},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9171.76},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6406.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10910.15},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6406.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6534.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6406.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6406.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5124.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6406.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6406.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6406.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11320.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6406.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Pancreas Except Malignancy With Mcc","code_information":[{"code":"438","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9790.91,"maximum":23371.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23371.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12238.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14606.0},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17897.31},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12238.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21289.51},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12238.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12483.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12238.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12238.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9790.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12238.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12238.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12238.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22090.27},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12238.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12087.56,"10th_percentile":12087.56,"90th_percentile":12087.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12777.65,"10th_percentile":12777.65,"90th_percentile":12777.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10538.15,"10th_percentile":10538.15,"90th_percentile":10538.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":4664.77,"10th_percentile":4664.77,"90th_percentile":4664.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12087.55,"10th_percentile":12087.55,"90th_percentile":12115.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11876.2,"10th_percentile":11876.2,"90th_percentile":11876.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Pancreas Except Malignancy With Cc","code_information":[{"code":"439","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5052.22,"maximum":12456.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12456.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6315.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7784.37},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9538.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6315.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11346.39},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6315.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6441.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6315.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6315.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5052.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6315.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6315.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6315.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11773.16},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6315.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":10628.63,"10th_percentile":10628.63,"90th_percentile":10628.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11100.28,"10th_percentile":7102.45,"90th_percentile":19568.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":8698.0,"10th_percentile":8698.0,"90th_percentile":8698.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2852.91,"10th_percentile":2852.91,"90th_percentile":2852.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6250.72,"10th_percentile":6250.72,"90th_percentile":6250.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":11788.58,"10th_percentile":11788.58,"90th_percentile":11788.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5998.25,"10th_percentile":140.0,"90th_percentile":6170.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Pancreas Except Malignancy Without Cc/Mcc","code_information":[{"code":"440","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3732.1,"maximum":8845.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8845.79},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4665.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5528.1},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6773.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4665.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8057.68},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4665.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4758.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4665.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4665.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3732.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4665.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4665.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4665.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8360.75},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4665.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14839.17,"10th_percentile":10103.48,"90th_percentile":19512.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":1948.0,"10th_percentile":1948.0,"90th_percentile":1948.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4619.51,"10th_percentile":4619.51,"90th_percentile":4621.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":3243.91,"10th_percentile":3243.91,"90th_percentile":3243.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc","code_information":[{"code":"441","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10778.9,"maximum":27023.69,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27023.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13473.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16888.21},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20693.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13473.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24616.04},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13473.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13743.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13473.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13473.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10778.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13473.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13473.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13473.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25541.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13473.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18620.01,"10th_percentile":18620.01,"90th_percentile":18620.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13098.36,"10th_percentile":13098.36,"90th_percentile":13098.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13660.12,"10th_percentile":13660.12,"90th_percentile":13660.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13045.12,"10th_percentile":13045.12,"90th_percentile":13045.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc","code_information":[{"code":"442","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5797.55,"maximum":14236.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14236.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7246.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8897.21},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10902.11},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7246.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12968.46},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7246.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7391.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7246.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7246.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5797.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7246.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7246.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7246.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13456.24},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7246.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10014.99,"10th_percentile":10014.99,"90th_percentile":56204.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12203.62,"10th_percentile":12203.62,"90th_percentile":12203.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":13527.71,"10th_percentile":13527.71,"90th_percentile":13527.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7050.14,"10th_percentile":7050.14,"90th_percentile":7050.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without Cc/Mcc","code_information":[{"code":"443","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4202.37,"maximum":10215.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10215.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5252.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6384.27},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7822.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5252.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9305.63},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5252.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5358.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5252.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5252.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4202.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5252.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5252.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5252.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9655.65},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5252.96,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6059.39,"10th_percentile":6059.39,"90th_percentile":6059.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":7369.94,"10th_percentile":7369.94,"90th_percentile":7369.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of The Biliary Tract With Mcc","code_information":[{"code":"444","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10035.36,"maximum":24704.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24704.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12544.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15439.01},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18918.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12544.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22503.7},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12544.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12795.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12544.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12544.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10035.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12544.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12544.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12544.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23350.13},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12544.2,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12167.25,"10th_percentile":12167.25,"90th_percentile":12167.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of The Biliary Tract With Cc","code_information":[{"code":"445","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6572.92,"maximum":16116.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16116.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8216.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10072.14},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12341.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8216.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14681.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8216.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8380.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8216.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8216.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6572.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8216.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8216.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8216.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15233.22},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8216.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6133.65,"10th_percentile":6133.65,"90th_percentile":8114.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6412.32,"10th_percentile":6412.32,"90th_percentile":6412.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":13645.12,"10th_percentile":13645.12,"90th_percentile":13645.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8117.45,"10th_percentile":8117.45,"90th_percentile":8117.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1518.64,"10th_percentile":1518.64,"90th_percentile":1518.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":280.59,"10th_percentile":280.59,"90th_percentile":7987.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of The Biliary Tract Without Cc/Mcc","code_information":[{"code":"446","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4968.73,"maximum":12041.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12041.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6210.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7524.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9220.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6210.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10968.22},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6210.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6335.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6210.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6210.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4968.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6210.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6210.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6210.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11380.77},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6210.91,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2710.89,"10th_percentile":2710.89,"90th_percentile":2710.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8789.03,"10th_percentile":8789.03,"90th_percentile":8789.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6299.83,"10th_percentile":6299.83,"90th_percentile":6299.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":924.2,"10th_percentile":924.2,"90th_percentile":924.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":1274.0,"10th_percentile":1274.0,"90th_percentile":1274.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6062.46,"10th_percentile":6062.46,"90th_percentile":6062.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Level Spinal Fusion Except Cervical With Mcc","code_information":[{"code":"447","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":40129.42,"maximum":103278.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":103278.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50161.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":64543.25},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79087.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50161.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":94077.39},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50161.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51165.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50161.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50161.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40129.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":50161.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50161.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50161.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":97615.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50161.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":42998.9,"10th_percentile":42998.9,"90th_percentile":42998.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Multiple Level Spinal Fusion Except Cervical Without Mcc","code_information":[{"code":"448","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25470.07,"maximum":64493.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64493.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31837.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40304.32},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49386.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31837.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58747.05},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31837.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32474.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31837.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31837.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25470.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31837.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31837.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31837.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60956.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31837.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30028.76,"10th_percentile":30028.76,"90th_percentile":31441.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":85437.45,"10th_percentile":65596.87,"90th_percentile":116767.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30875.86,"10th_percentile":30875.86,"90th_percentile":30875.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":73908.34,"10th_percentile":73908.34,"90th_percentile":73908.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":31443.15,"10th_percentile":31441.55,"90th_percentile":31465.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":59430.57,"10th_percentile":59430.57,"90th_percentile":59430.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30868.86,"10th_percentile":30868.86,"90th_percentile":30884.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Revision Of Hip Or Knee Prosthesis","code_information":[{"code":"449","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":30581.51,"maximum":48935.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48935.03},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30581.51},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37472.74},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44575.2},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46251.81}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Single Level Spinal Fusion Except Cervical With Mcc","code_information":[{"code":"450","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32009.36,"maximum":77603.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77603.04},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":48497.32},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59425.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70689.05},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40811.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32009.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":40011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73347.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":40011.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Single Level Spinal Fusion Except Cervical Without Mcc","code_information":[{"code":"451","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19401.65,"maximum":48330.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48330.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24252.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30203.45},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37009.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24252.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44024.16},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24252.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24737.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24252.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24252.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19401.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24252.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24252.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24252.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45680.03},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24252.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23950.4,"10th_percentile":23950.4,"90th_percentile":23950.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":54578.33,"10th_percentile":32266.56,"90th_percentile":74319.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23026.62,"10th_percentile":23026.62,"90th_percentile":23026.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23950.4,"10th_percentile":23950.4,"90th_percentile":23958.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":47206.72,"10th_percentile":45270.83,"90th_percentile":48213.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23535.79,"10th_percentile":23535.79,"90th_percentile":23535.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection With Mcc","code_information":[{"code":"456","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":50470.47,"maximum":112998.05,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":112998.05},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63088.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":70617.11},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":86529.97},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63088.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":102930.58},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63088.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":64349.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63088.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63088.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":50470.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":63088.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63088.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63088.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":106802.1},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":63088.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":117765.25,"10th_percentile":117765.25,"90th_percentile":117765.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection With Cc","code_information":[{"code":"457","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":35814.14,"maximum":79573.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":79573.54},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44767.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":49728.77},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60934.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44767.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72484.0},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44767.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45663.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44767.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44767.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35814.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":44767.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44767.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44767.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":75210.34},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44767.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":44450.96,"10th_percentile":44450.96,"90th_percentile":44450.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Without Cc/Mcc","code_information":[{"code":"458","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25060.46,"maximum":59858.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59858.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31325.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37407.77},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45837.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31325.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54525.07},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31325.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31952.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31325.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31325.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25060.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31325.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31325.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31325.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56575.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31325.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30950.92,"10th_percentile":30950.92,"90th_percentile":30950.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc","code_information":[{"code":"461","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":33170.91,"maximum":73700.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73700.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41463.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":46058.51},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56437.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41463.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67134.27},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41463.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42292.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41463.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41463.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":33170.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41463.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41463.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41463.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69659.39},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41463.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc","code_information":[{"code":"462","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15975.85,"maximum":42296.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42296.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19969.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26433.12},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32389.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19969.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38528.57},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19969.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20369.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19969.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19969.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15975.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19969.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19969.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19969.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39977.74},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19969.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Wound Debridement Or Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders With","code_information":[{"code":"463","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":34230.96,"maximum":76056.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":76056.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42788.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":47530.87},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":58241.48},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42788.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69280.38},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42788.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":43644.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42788.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42788.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":34230.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42788.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42788.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42788.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":71886.21},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42788.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Wound Debridement Or Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders With","code_information":[{"code":"464","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18706.76,"maximum":47092.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47092.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23383.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29429.74},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36061.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23383.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42896.41},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23383.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23851.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23383.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23383.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18706.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23383.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23383.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23383.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44509.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23383.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23096.59,"10th_percentile":23096.59,"90th_percentile":23096.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":55468.5,"10th_percentile":55468.5,"90th_percentile":55468.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16814.82,"10th_percentile":16814.82,"90th_percentile":16814.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22681.5,"10th_percentile":22681.5,"90th_percentile":22681.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Wound Debridement Or Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders With","code_information":[{"code":"465","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10953.06,"maximum":36803.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36803.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23000.07},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28182.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33524.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13965.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10953.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34785.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12877.43,"10th_percentile":12877.43,"90th_percentile":12877.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":34378.57,"10th_percentile":34378.57,"90th_percentile":34378.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":25557.33,"10th_percentile":25557.33,"90th_percentile":25557.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc Or Total Ankle Repl","code_information":[{"code":"469","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18217.27,"maximum":46085.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46085.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22771.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28800.58},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35290.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22771.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41979.35},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22771.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23227.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22771.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22771.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18217.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22771.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22771.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22771.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43558.31},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22771.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22499.44,"10th_percentile":22499.44,"90th_percentile":22499.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13630.16,"10th_percentile":13630.16,"90th_percentile":13630.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":22056.87,"10th_percentile":22056.87,"90th_percentile":22056.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20053.18,"10th_percentile":20053.18,"90th_percentile":20053.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc","code_information":[{"code":"470","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11584.9,"maximum":29001.61,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29001.61},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14481.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18124.3},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22208.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14481.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26417.74},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14481.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14770.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14481.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14481.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11584.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14481.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14481.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14481.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27411.38},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14481.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14308.88,"10th_percentile":14308.88,"90th_percentile":14341.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"1 through 10","median_amount":161414.36,"10th_percentile":161414.36,"90th_percentile":161414.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":36361.69,"10th_percentile":36361.69,"90th_percentile":36361.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13307.8,"10th_percentile":13307.8,"90th_percentile":13307.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":19837.68,"10th_percentile":19837.68,"90th_percentile":19837.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":5066.17,"10th_percentile":5066.17,"90th_percentile":5066.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14302.34,"10th_percentile":14302.34,"90th_percentile":14307.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":27031.6,"10th_percentile":27031.6,"90th_percentile":27031.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14046.58,"10th_percentile":14046.58,"90th_percentile":14046.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cervical Spinal Fusion With Mcc","code_information":[{"code":"471","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":29000.98,"maximum":73187.55,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73187.55},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36251.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45737.9},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56044.48},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36251.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66666.97},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36251.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36976.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36251.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36251.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29000.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36251.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36251.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36251.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69174.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36251.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cervical Spinal Fusion With Cc","code_information":[{"code":"472","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17694.15,"maximum":44197.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44197.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22117.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27621.02},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33845.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22117.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40260.04},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22117.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22560.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22117.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22117.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17694.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22117.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22117.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22117.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41774.33},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22117.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":70674.08,"10th_percentile":70674.08,"90th_percentile":70674.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21118.72,"10th_percentile":21118.72,"90th_percentile":21118.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":49326.22,"10th_percentile":49326.22,"90th_percentile":49326.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21845.02,"10th_percentile":21844.97,"90th_percentile":21848.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21417.29,"10th_percentile":21417.29,"90th_percentile":21422.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cervical Spinal Fusion Without Cc/Mcc","code_information":[{"code":"473","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14662.34,"maximum":36363.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36363.22},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18327.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22724.87},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27845.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18327.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33123.47},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18327.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18694.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18327.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18327.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14662.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18327.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18327.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18327.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34369.34},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18327.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":45947.79,"10th_percentile":45947.79,"90th_percentile":45947.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":59805.26,"10th_percentile":59805.26,"90th_percentile":59805.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18107.94,"10th_percentile":18107.94,"90th_percentile":18107.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc Or Insertion Of Antib","code_information":[{"code":"474","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25782.98,"maximum":62472.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62472.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32228.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39041.36},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47838.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32228.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56906.18},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32228.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32873.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32228.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32228.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25782.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32228.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32228.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32228.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59046.59},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32228.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc","code_information":[{"code":"475","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13667.76,"maximum":32993.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32993.04},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17084.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20618.7},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25264.92},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17084.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30053.55},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17084.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17426.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17084.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17084.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13667.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17084.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17084.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17084.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31183.95},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17084.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation For Musculoskeletal System And Connective Tissue Disorders Without Cc/Mcc","code_information":[{"code":"476","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7088.23,"maximum":16836.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16836.06},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8860.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10521.54},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12892.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8860.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15336.06},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8860.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9037.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8860.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8860.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7088.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8860.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8860.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8860.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15912.9},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8860.29,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Biopsies Of Musculoskeletal System And Connective Tissue With Mcc Or Insertion Of Antibiotic-Eluting","code_information":[{"code":"477","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20748.18,"maximum":50450.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50450.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25935.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31528.49},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38633.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25935.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45955.52},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25935.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26453.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25935.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25935.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20748.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25935.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25935.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25935.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47684.04},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25935.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25662.43,"10th_percentile":25662.43,"90th_percentile":25662.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":49228.05,"10th_percentile":49228.05,"90th_percentile":49228.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25617.43,"10th_percentile":25617.43,"90th_percentile":25617.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":47122.09,"10th_percentile":47122.09,"90th_percentile":47122.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19898.81,"10th_percentile":19898.81,"90th_percentile":19898.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Biopsies Of Musculoskeletal System And Connective Tissue With Cc","code_information":[{"code":"478","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14769.86,"maximum":36084.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36084.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18462.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22550.66},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27632.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18462.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32869.55},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18462.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18831.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18462.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18462.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14769.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18462.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18462.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18462.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34105.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18462.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":30543.29,"10th_percentile":30543.29,"90th_percentile":30543.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":27748.51,"10th_percentile":27748.51,"90th_percentile":27748.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16551.38,"10th_percentile":16153.76,"90th_percentile":18283.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/Mcc","code_information":[{"code":"479","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11164.48,"maximum":27480.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27480.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17173.6},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21043.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25032.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14234.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11164.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13955.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25973.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13955.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip And Femur Procedures Except Major Joint With Mcc Or Insertion Of Antibiotic-Eluting Bone Void Fi","code_information":[{"code":"480","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17491.15,"maximum":43287.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43287.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21863.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27052.09},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33148.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21863.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39430.77},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21863.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22301.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21863.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21863.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17491.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21863.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21863.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21863.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40913.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21863.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15528.77,"10th_percentile":15528.77,"90th_percentile":15528.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":150.0,"10th_percentile":150.0,"90th_percentile":150.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21616.21,"10th_percentile":21616.21,"90th_percentile":21636.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21183.61,"10th_percentile":21183.61,"90th_percentile":21183.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip And Femur Procedures Except Major Joint With Cc","code_information":[{"code":"481","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12579.48,"maximum":31531.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31531.1},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15724.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19705.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24145.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15724.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28721.86},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15724.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16038.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15724.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15724.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12579.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15724.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15724.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15724.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29802.17},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15724.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":141685.55,"10th_percentile":141685.55,"90th_percentile":141685.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15528.77,"10th_percentile":15528.77,"90th_percentile":15566.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21717.28,"10th_percentile":21717.28,"90th_percentile":21717.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":28640.09,"10th_percentile":28640.09,"90th_percentile":28640.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15531.17,"10th_percentile":741.18,"90th_percentile":15566.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":66868.97,"10th_percentile":66868.97,"90th_percentile":66868.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15268.52,"10th_percentile":14696.61,"90th_percentile":15280.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip And Femur Procedures Except Major Joint Without Cc/Mcc","code_information":[{"code":"482","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9795.72,"maximum":24311.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24311.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12244.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15193.46},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18617.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12244.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22145.79},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12244.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12489.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12244.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12244.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9795.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12244.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12244.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12244.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22978.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12244.65,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10364.75,"10th_percentile":10364.75,"90th_percentile":10364.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12124.34,"10th_percentile":12124.34,"90th_percentile":12124.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4968.43,"10th_percentile":4968.43,"90th_percentile":4968.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Joint Or Limb Reattachment Procedures Of Upper Extremities","code_information":[{"code":"483","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16647.92,"maximum":42933.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42933.06},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20809.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26830.63},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32876.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20809.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39107.97},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20809.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21226.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20809.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20809.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16647.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20809.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20809.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20809.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40578.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20809.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":52629.96,"10th_percentile":52629.96,"90th_percentile":52629.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20552.55,"10th_percentile":2710.89,"90th_percentile":20558.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":47307.17,"10th_percentile":47307.17,"90th_percentile":47307.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":6121.92,"10th_percentile":6121.92,"90th_percentile":6121.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21173.67,"10th_percentile":21173.67,"90th_percentile":21173.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20159.68,"10th_percentile":20159.68,"90th_percentile":20159.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Knee Procedures Without Principal Diagnosis Of Infection With Cc/Mcc","code_information":[{"code":"488","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10623.94,"maximum":32917.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32917.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13279.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20571.45},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25207.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13279.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29984.67},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13279.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13545.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13279.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13279.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10623.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13279.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13279.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13279.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31112.48},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13279.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Knee Procedures Without Principal Diagnosis Of Infection Without Cc/Mcc","code_information":[{"code":"489","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6707.46,"maximum":19447.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19447.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12153.29},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14891.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17714.47},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8552.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6707.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18380.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11586.8,"10th_percentile":11586.8,"90th_percentile":11586.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc Or Insertion Of Antibioti","code_information":[{"code":"492","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22051.48,"maximum":54735.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54735.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27564.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34206.37},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41914.43},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27564.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49858.75},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27564.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28115.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27564.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27564.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22051.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27564.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27564.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27564.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51734.08},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27564.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6987.41,"10th_percentile":6987.41,"90th_percentile":6987.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5426.39,"10th_percentile":5426.39,"90th_percentile":5426.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25528.45,"10th_percentile":25528.45,"90th_percentile":25528.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc","code_information":[{"code":"493","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15231.71,"maximum":37847.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37847.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19039.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23652.39},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28982.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19039.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34475.42},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19039.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19420.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19039.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19039.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15231.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19039.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19039.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19039.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35772.14},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19039.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14899.52,"10th_percentile":14899.52,"90th_percentile":14899.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17516.11,"10th_percentile":17516.11,"90th_percentile":17516.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18479.86,"10th_percentile":18479.86,"90th_percentile":18479.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc","code_information":[{"code":"494","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12050.96,"maximum":30030.61,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30030.61},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15063.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18767.36},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22996.39},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15063.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27355.05},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15063.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15364.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15063.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15063.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12050.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15063.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15063.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15063.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28383.96},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15063.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33609.77,"10th_percentile":33609.77,"90th_percentile":33609.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13771.79,"10th_percentile":13771.79,"90th_percentile":13771.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14897.32,"10th_percentile":14897.32,"90th_percentile":14897.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14608.0,"10th_percentile":14608.0,"90th_percentile":14608.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Mcc","code_information":[{"code":"495","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21775.81,"maximum":49462.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49462.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27219.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30911.38},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37876.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27219.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45056.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27219.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27764.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27219.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27219.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21775.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27219.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27219.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27219.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46750.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27219.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Cc","code_information":[{"code":"496","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10834.15,"maximum":26363.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26363.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13542.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16475.87},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20188.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13542.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24015.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13542.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13813.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13542.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13542.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10834.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13542.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13542.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13542.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24918.29},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13542.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":20437.05,"10th_percentile":20437.05,"90th_percentile":20437.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":1274.0,"10th_percentile":1274.0,"90th_percentile":1274.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Without Cc/Mcc","code_information":[{"code":"497","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7257.0,"maximum":17368.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17368.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9071.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10854.19},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13300.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9071.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15820.93},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9071.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9252.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9071.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9071.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7257.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9071.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9071.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9071.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16416.0},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9071.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc/Mcc","code_information":[{"code":"498","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18118.78,"maximum":47275.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47275.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29544.64},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36202.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43063.88},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23101.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18118.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22648.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44683.64},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22648.47,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22371.26,"10th_percentile":22371.26,"90th_percentile":22371.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Soft Tissue Procedures With Mcc","code_information":[{"code":"500","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19007.66,"maximum":49820.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49820.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23759.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31134.69},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38150.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23759.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45381.51},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23759.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24234.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23759.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23759.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19007.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23759.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23759.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23759.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47088.44},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23759.57,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Soft Tissue Procedures With Cc","code_information":[{"code":"501","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10499.02,"maximum":27671.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27671.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13123.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17293.14},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21189.97},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13123.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25206.25},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13123.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13386.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13123.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13123.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10499.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13123.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13123.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13123.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26154.33},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13123.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33643.38,"10th_percentile":33643.38,"90th_percentile":33643.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4099.51,"10th_percentile":4099.51,"90th_percentile":4099.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12719.3,"10th_percentile":12719.3,"90th_percentile":12719.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Soft Tissue Procedures Without Cc/Mcc","code_information":[{"code":"502","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8083.42,"maximum":21248.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21248.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10104.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13279.1},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16271.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10104.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19355.45},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10104.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10306.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10104.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10104.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8083.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10104.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10104.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10104.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20083.46},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10104.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13963.71,"10th_percentile":13963.71,"90th_percentile":13963.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":17345.76,"10th_percentile":17345.76,"90th_percentile":17345.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Foot Procedures With Mcc","code_information":[{"code":"503","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16763.23,"maximum":41153.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41153.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20954.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25718.71},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31514.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20954.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37487.25},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20954.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21373.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20954.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20954.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16763.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20954.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20954.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20954.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38897.26},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20954.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Foot Procedures With Cc","code_information":[{"code":"504","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11226.34,"maximum":26319.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26319.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14032.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16448.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20154.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14032.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23974.5},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14032.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14313.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14032.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14032.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11226.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14032.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14032.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14032.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24876.25},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14032.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Foot Procedures Without Cc/Mcc","code_information":[{"code":"505","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10767.48,"maximum":26319.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26319.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13459.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16448.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20154.49},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13459.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23974.5},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13459.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13728.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13459.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13459.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10767.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13459.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13459.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13459.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24876.25},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13459.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Thumb Or Joint Procedures","code_information":[{"code":"506","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8103.24,"maximum":18004.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18004.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10129.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11251.7},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13787.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10129.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16400.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10129.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10331.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10129.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10129.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8103.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10129.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10129.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10129.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17017.2},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10129.05,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Shoulder Or Elbow Joint Procedures With Cc/Mcc","code_information":[{"code":"507","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10849.16,"maximum":27529.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27529.29},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13561.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17204.18},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21080.97},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13561.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25076.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13561.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13832.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13561.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13561.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10849.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13561.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13561.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13561.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26019.79},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13561.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Shoulder Or Elbow Joint Procedures Without Cc/Mcc","code_information":[{"code":"508","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9095.42,"maximum":20209.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20209.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11369.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12629.56},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15475.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11369.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18408.68},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11369.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11596.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11369.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11369.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9095.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11369.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11369.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11369.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19101.08},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11369.28,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc","code_information":[{"code":"510","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18141.0,"maximum":46381.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46381.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22676.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28985.9},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35517.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22676.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42249.47},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22676.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23129.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22676.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22676.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18141.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22676.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22676.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22676.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43838.59},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22676.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc","code_information":[{"code":"511","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12488.79,"maximum":31399.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31399.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15610.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19622.61},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24044.37},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15610.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28601.66},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15610.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15923.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15610.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15610.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12488.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15610.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15610.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15610.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29677.45},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15610.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15477.75,"10th_percentile":15477.75,"90th_percentile":15477.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23443.22,"10th_percentile":23443.22,"90th_percentile":23443.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15131.54,"10th_percentile":15131.54,"90th_percentile":15131.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/Mcc","code_information":[{"code":"512","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9942.26,"maximum":25257.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25257.79},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12427.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15784.63},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19341.54},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12427.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23007.47},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12427.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12676.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12427.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12427.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9942.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12427.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12427.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12427.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23872.85},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12427.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15199.78,"10th_percentile":15199.78,"90th_percentile":15199.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/Mcc","code_information":[{"code":"513","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9455.18,"maximum":22548.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22548.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11818.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14091.73},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17267.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11818.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20539.92},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11818.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12055.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11818.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11818.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9455.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11818.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11818.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11818.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21312.49},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11818.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/Mcc","code_information":[{"code":"514","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6139.89,"maximum":15119.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15119.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7674.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9448.54},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11577.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7674.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13772.07},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7674.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7828.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7674.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7674.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6139.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7674.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7674.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7674.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14290.08},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7674.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Musculoskeletal System And Connective Tissue O.R. Procedures With Mcc","code_information":[{"code":"515","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19140.39,"maximum":47286.27,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47286.27},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23925.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29551.13},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36210.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23925.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43073.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23925.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24404.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23925.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23925.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19140.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23925.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23925.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23925.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44693.45},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23925.49,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11393.2,"10th_percentile":11393.2,"90th_percentile":11393.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23261.33,"10th_percentile":23261.33,"90th_percentile":23261.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21339.13,"10th_percentile":21339.13,"90th_percentile":21339.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":35.42,"10th_percentile":35.42,"90th_percentile":35.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23631.38,"10th_percentile":23631.38,"90th_percentile":23631.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":47564.48,"10th_percentile":47564.48,"90th_percentile":47564.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23182.37,"10th_percentile":23182.37,"90th_percentile":23182.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Musculoskeletal System And Connective Tissue O.R. Procedures With Cc","code_information":[{"code":"516","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12480.98,"maximum":31403.59,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31403.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15601.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19625.39},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24047.77},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15601.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28605.71},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15601.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15913.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15601.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15601.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12480.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15601.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15601.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15601.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29681.65},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15601.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15437.3,"10th_percentile":15437.3,"90th_percentile":15454.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20296.26,"10th_percentile":20296.26,"90th_percentile":20296.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15166.72,"10th_percentile":15166.72,"90th_percentile":15166.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15436.95,"10th_percentile":15409.57,"90th_percentile":15463.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15106.49,"10th_percentile":15106.49,"90th_percentile":15141.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Musculoskeletal System And Connective Tissue O.R. Procedures Without Cc/Mcc","code_information":[{"code":"517","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9229.36,"maximum":23319.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23319.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11536.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14573.56},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17857.57},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11536.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21242.24},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11536.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11767.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11536.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11536.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9229.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11536.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11536.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11536.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22041.22},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11536.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":27539.32,"10th_percentile":27539.32,"90th_percentile":27539.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10697.42,"10th_percentile":10697.42,"90th_percentile":10697.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11213.8,"10th_percentile":11213.8,"90th_percentile":11213.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurostimulator","code_information":[{"code":"518","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22446.07,"maximum":55316.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55316.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28057.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34569.59},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42359.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28057.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50388.18},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28057.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28618.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28057.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28057.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22446.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28057.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28057.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28057.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52283.43},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28057.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":41072.0,"10th_percentile":41072.0,"90th_percentile":41072.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":59058.33,"10th_percentile":59058.33,"90th_percentile":59058.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":27713.59,"10th_percentile":27713.59,"90th_percentile":27713.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":1505.41,"10th_percentile":1505.41,"90th_percentile":1505.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21278.21,"10th_percentile":21278.21,"90th_percentile":21278.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Back And Neck Procedures Except Spinal Fusion With Cc","code_information":[{"code":"519","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12013.12,"maximum":30181.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30181.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15016.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18861.87},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23112.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15016.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27492.81},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15016.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15316.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15016.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15016.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12013.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15016.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15016.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15016.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28526.9},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15016.4,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11076.92,"10th_percentile":11076.92,"90th_percentile":11076.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20427.08,"10th_percentile":20427.08,"90th_percentile":20427.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14859.01,"10th_percentile":14859.01,"90th_percentile":14859.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14538.83,"10th_percentile":14538.83,"90th_percentile":14538.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Back And Neck Procedures Except Spinal Fusion Without Cc/Mcc","code_information":[{"code":"520","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8972.3,"maximum":23064.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23064.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11215.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14414.19},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17662.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11215.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21009.93},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11215.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11439.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11215.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11215.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8972.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11215.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11215.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11215.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21800.18},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11215.38,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":425.66,"10th_percentile":425.66,"90th_percentile":425.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc","code_information":[{"code":"521","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17238.3,"maximum":42280.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42280.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21547.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26422.93},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32377.07},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21547.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38513.71},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21547.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21978.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21547.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21547.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17238.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21547.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21547.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21547.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39962.32},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21547.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21279.84,"10th_percentile":21279.84,"90th_percentile":21279.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21279.84,"10th_percentile":21279.84,"90th_percentile":21282.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20899.59,"10th_percentile":20899.59,"90th_percentile":20899.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc","code_information":[{"code":"522","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12718.82,"maximum":31369.48,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31369.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15898.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19604.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24021.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15898.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28574.64},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15898.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16216.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15898.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15898.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12718.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15898.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15898.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15898.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29649.42},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15898.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15729.75,"10th_percentile":15724.45,"90th_percentile":15748.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15731.75,"10th_percentile":15718.75,"90th_percentile":15736.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15408.49,"10th_percentile":15249.7,"90th_percentile":15425.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive Or Complex Spinal Fusion Procedures Except Cervical With Mcc","code_information":[{"code":"523","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":127299.09,"maximum":203697.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":203697.77},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":127299.09},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":155984.66},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":185549.48},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":192528.54}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive Or Complex Spinal Fusion Procedures Except Cervical With Cc","code_information":[{"code":"524","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":91105.17,"maximum":145782.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":145782.03},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":91105.17},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":111634.8},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":132793.69},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":137788.45}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive Or Complex Spinal Fusion Procedures Except Cervical Without Cc/Mcc","code_information":[{"code":"525","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":67595.47,"maximum":108162.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":108162.97},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":67595.47},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":82827.43},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":98526.27},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":102232.13}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fractures Of Femur With Mcc","code_information":[{"code":"533","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9415.54,"maximum":21711.18,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21711.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11769.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13568.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16625.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11769.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19776.84},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11769.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12004.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11769.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11769.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9415.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11769.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11769.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11769.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20520.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11769.43,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fractures Of Femur Without Mcc","code_information":[{"code":"534","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4841.4,"maximum":12451.71,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12451.71},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6051.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7781.59},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9535.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6051.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11342.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6051.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6172.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6051.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6051.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4841.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6051.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6051.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6051.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11768.96},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6051.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fractures Of Hip And Pelvis With Mcc","code_information":[{"code":"535","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7699.64,"maximum":18865.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18865.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9624.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11790.06},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14446.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9624.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17185.03},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9624.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9817.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9624.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9624.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7699.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9624.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9624.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9624.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17831.41},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9624.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9506.42,"10th_percentile":9504.82,"90th_percentile":9543.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9440.19,"10th_percentile":9440.19,"90th_percentile":9440.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fractures Of Hip And Pelvis Without Mcc","code_information":[{"code":"536","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4850.42,"maximum":11962.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11962.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6063.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7475.81},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9160.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6063.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10896.64},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6063.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6184.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6063.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6063.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4850.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6063.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6063.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6063.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11306.5},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6063.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6002.6,"10th_percentile":6002.6,"90th_percentile":6027.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5894.16,"10th_percentile":5894.16,"90th_percentile":5894.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5987.6,"10th_percentile":5987.6,"90th_percentile":5989.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1535.43,"10th_percentile":1535.43,"90th_percentile":1535.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5892.2,"10th_percentile":5892.2,"90th_percentile":5925.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh With Cc/Mcc","code_information":[{"code":"537","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5731.49,"maximum":13563.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13563.74},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7164.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8476.54},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10386.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7164.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12355.29},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7164.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7307.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7164.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7164.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5731.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7164.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7164.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7164.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12820.01},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7164.36,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":10051.64,"10th_percentile":10051.64,"90th_percentile":10051.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh Without Cc/Mcc","code_information":[{"code":"538","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4326.1,"maximum":10553.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10553.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5407.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6595.54},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8081.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5407.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9613.57},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5407.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5515.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5407.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5407.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4326.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5407.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5407.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5407.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9975.17},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5407.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Osteomyelitis With Mcc","code_information":[{"code":"539","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11829.94,"maximum":28728.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28728.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14787.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17953.8},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21999.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14787.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26169.23},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14787.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15083.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14787.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14787.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11829.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14787.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14787.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14787.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27153.53},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14787.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14604.85,"10th_percentile":14604.85,"90th_percentile":14604.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32112.81,"10th_percentile":32112.81,"90th_percentile":32112.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9444.04,"10th_percentile":9444.04,"90th_percentile":9444.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Osteomyelitis With Cc","code_information":[{"code":"540","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7785.53,"maximum":19386.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19386.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12115.3},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14845.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17659.1},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9926.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7785.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18323.31},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9610.84,"10th_percentile":9610.84,"90th_percentile":9610.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13449.11,"10th_percentile":13449.11,"90th_percentile":25988.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3743.39,"10th_percentile":3743.39,"90th_percentile":3743.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":212.02,"10th_percentile":212.02,"90th_percentile":212.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Osteomyelitis Without Cc/Mcc","code_information":[{"code":"541","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4729.09,"maximum":12296.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12296.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5911.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7684.29},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9415.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5911.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11200.53},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5911.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6029.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5911.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5911.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4729.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5911.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5911.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5911.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11621.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5911.36,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Mcc","code_information":[{"code":"542","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10609.53,"maximum":25514.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25514.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13261.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15944.93},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19537.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13261.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23241.12},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13261.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13527.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13261.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13261.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10609.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13261.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13261.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13261.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24115.29},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13261.91,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10893.76,"10th_percentile":10893.76,"90th_percentile":10893.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13108.94,"10th_percentile":13108.94,"90th_percentile":13108.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":85935.17,"10th_percentile":85935.17,"90th_percentile":85935.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Cc","code_information":[{"code":"543","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6174.13,"maximum":14913.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14913.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7717.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9319.74},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11419.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7717.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13584.33},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7717.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7872.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7717.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7717.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6174.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7717.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7717.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7717.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14095.28},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7717.66,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14649.0,"10th_percentile":14649.0,"90th_percentile":14649.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7502.7,"10th_percentile":7502.7,"90th_percentile":7502.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7631.65,"10th_percentile":7631.65,"90th_percentile":7631.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1788.34,"10th_percentile":1788.34,"90th_percentile":1788.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":140.0,"10th_percentile":140.0,"90th_percentile":140.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy Without Cc/Mcc","code_information":[{"code":"544","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4532.1,"maximum":10977.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10977.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5665.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6860.55},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8406.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5665.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9999.84},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5665.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5778.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5665.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5665.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4532.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5665.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5665.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5665.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10375.97},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5665.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4728.14,"10th_percentile":4728.14,"90th_percentile":4728.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5507.16,"10th_percentile":5507.16,"90th_percentile":5507.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Connective Tissue Disorders With Mcc","code_information":[{"code":"545","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14904.98,"maximum":35440.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35440.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18631.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22148.52},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27139.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18631.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32283.39},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18631.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19003.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18631.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18631.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14904.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18631.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18631.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18631.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33497.66},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18631.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Connective Tissue Disorders With Cc","code_information":[{"code":"546","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6927.27,"maximum":17399.48,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17399.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8659.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10873.65},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13323.92},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8659.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15849.29},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8659.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8832.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8659.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8659.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6927.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8659.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8659.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8659.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16445.43},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8659.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10949.52,"10th_percentile":10949.52,"90th_percentile":10949.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Connective Tissue Disorders Without Cc/Mcc","code_information":[{"code":"547","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5022.18,"maximum":11158.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11158.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6277.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6973.59},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8545.02},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6277.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10164.62},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6277.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6403.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6277.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6277.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5022.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6277.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6277.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6277.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10546.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6277.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Septic Arthritis With Mcc","code_information":[{"code":"548","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11596.9,"maximum":28928.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28928.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14496.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18078.89},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22152.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14496.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26351.56},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14496.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14786.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14496.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14496.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11596.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14496.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14496.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14496.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27342.72},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14496.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Septic Arthritis With Cc","code_information":[{"code":"549","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7250.39,"maximum":16947.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16947.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9062.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10591.04},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12977.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9062.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15437.36},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9062.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9244.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9062.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9062.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7250.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9062.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9062.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9062.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16018.0},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9062.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Septic Arthritis Without Cc/Mcc","code_information":[{"code":"550","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5249.81,"maximum":12745.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12745.29},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6562.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7965.05},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9759.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6562.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11609.76},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6562.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6693.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6562.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6562.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5249.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6562.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6562.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6562.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12046.43},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6562.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Medical Back Problems With Mcc","code_information":[{"code":"551","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10066.58,"maximum":24242.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24242.15},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12583.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15149.91},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18563.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12583.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22082.31},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12583.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12834.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12583.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12583.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10066.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12583.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12583.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12583.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22912.89},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12583.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12426.71,"10th_percentile":12426.71,"90th_percentile":12426.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12430.29,"10th_percentile":12430.29,"90th_percentile":12430.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Medical Back Problems Without Mcc","code_information":[{"code":"552","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5773.53,"maximum":14207.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14207.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7216.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8878.68},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10879.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7216.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12941.45},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7216.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7361.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7216.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7216.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5773.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7216.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7216.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7216.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13428.21},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7216.91,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":14253.2,"10th_percentile":14253.2,"90th_percentile":14253.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7127.15,"10th_percentile":7127.15,"90th_percentile":7127.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12464.45,"10th_percentile":9973.49,"90th_percentile":22770.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7015.92,"10th_percentile":4838.87,"90th_percentile":7015.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":11633.4,"10th_percentile":11633.4,"90th_percentile":11633.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":7127.15,"10th_percentile":467.76,"90th_percentile":28233.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13619.65,"10th_percentile":5716.22,"90th_percentile":28393.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":31497.71,"10th_percentile":31497.71,"90th_percentile":31497.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":280.59,"10th_percentile":130.0,"90th_percentile":7008.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bone Diseases And Arthropathies With Mcc","code_information":[{"code":"553","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7785.53,"maximum":18521.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18521.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11575.09},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14183.42},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16871.7},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9926.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7785.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17506.29},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9731.91,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":870.0,"10th_percentile":870.0,"90th_percentile":870.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Bone Diseases And Arthropathies Without Mcc","code_information":[{"code":"554","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4985.54,"maximum":12347.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12347.93},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7716.72},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9455.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11247.8},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6356.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4985.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6231.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11670.86},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6231.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":11721.84,"10th_percentile":11721.84,"90th_percentile":11721.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6155.0,"10th_percentile":6155.0,"90th_percentile":6155.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6154.42,"10th_percentile":6154.42,"90th_percentile":6190.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6066.75,"10th_percentile":6066.75,"90th_percentile":6066.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc","code_information":[{"code":"555","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7938.68,"maximum":19138.69,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19138.69},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9923.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11960.55},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14655.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9923.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17433.54},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9923.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10121.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9923.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9923.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7938.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9923.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9923.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9923.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18089.27},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9923.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9811.01,"10th_percentile":9811.01,"90th_percentile":9811.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9817.18,"10th_percentile":9817.18,"90th_percentile":9817.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc","code_information":[{"code":"556","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4988.55,"maximum":12172.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12172.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6235.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7607.39},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9321.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6235.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11088.43},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6235.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6360.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6235.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6235.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4988.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6235.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6235.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6235.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11505.49},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6235.69,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6181.82,"10th_percentile":6181.82,"90th_percentile":6181.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21450.68,"10th_percentile":21450.68,"90th_percentile":21450.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":7921.44,"10th_percentile":7921.44,"90th_percentile":7921.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Tendonitis, Myositis And Bursitis With Mcc","code_information":[{"code":"557","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8930.26,"maximum":22067.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22067.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11162.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13790.59},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16898.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11162.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20100.98},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11162.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11386.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11162.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11162.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8930.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11162.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11162.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11162.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20857.04},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11162.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":828.11,"10th_percentile":828.11,"90th_percentile":828.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9697.95,"10th_percentile":9697.95,"90th_percentile":9697.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11027.41,"10th_percentile":11027.41,"90th_percentile":11083.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Tendonitis, Myositis And Bursitis Without Mcc","code_information":[{"code":"558","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5364.52,"maximum":13156.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13156.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6705.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8221.72},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10074.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6705.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11983.87},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6705.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6839.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6705.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6705.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5364.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6705.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6705.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6705.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12434.62},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6705.65,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":12612.88,"10th_percentile":12612.88,"90th_percentile":12612.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2710.89,"10th_percentile":2710.89,"90th_percentile":2710.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9266.95,"10th_percentile":7395.85,"90th_percentile":14526.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":4704.04,"10th_percentile":4704.04,"90th_percentile":10372.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6635.04,"10th_percentile":6635.04,"90th_percentile":7872.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2220.09,"10th_percentile":2220.09,"90th_percentile":2220.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":13331.01,"10th_percentile":13331.01,"90th_percentile":13331.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aftercare, Musculoskeletal System And Connective Tissue With Mcc","code_information":[{"code":"559","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11200.51,"maximum":26817.59,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26817.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14000.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16759.41},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20535.98},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14000.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24428.3},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14000.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14280.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14000.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14000.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11200.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14000.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14000.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14000.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25347.12},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14000.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":24103.83,"10th_percentile":24103.83,"90th_percentile":24103.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1027.62,"10th_percentile":1027.62,"90th_percentile":1027.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aftercare, Musculoskeletal System And Connective Tissue With Cc","code_information":[{"code":"560","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6763.31,"maximum":16656.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16656.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8454.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10409.42},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12755.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8454.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15172.64},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8454.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8623.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8454.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8454.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6763.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8454.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8454.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8454.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15743.33},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8454.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8373.43,"10th_percentile":8373.43,"90th_percentile":8373.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16046.93,"10th_percentile":16046.93,"90th_percentile":16046.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18404.48,"10th_percentile":18404.48,"90th_percentile":18404.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8230.04,"10th_percentile":8230.04,"90th_percentile":8230.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc","code_information":[{"code":"561","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4828.19,"maximum":12244.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12244.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6035.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7651.86},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9376.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6035.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11153.25},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6035.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6155.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6035.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6035.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4828.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6035.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6035.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6035.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11572.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6035.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8340.46,"10th_percentile":8340.46,"90th_percentile":8340.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh With Mcc","code_information":[{"code":"562","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8557.29,"maximum":20729.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20729.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10696.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12954.79},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15874.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10696.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18882.74},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10696.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10910.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10696.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10696.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8557.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10696.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10696.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10696.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19592.97},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10696.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10565.65,"10th_percentile":10565.65,"90th_percentile":10565.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10405.91,"10th_percentile":10405.91,"90th_percentile":10405.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Without Mcc","code_information":[{"code":"563","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5378.34,"maximum":13317.61,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13317.61},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6722.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8322.72},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10198.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6722.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12131.09},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6722.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6857.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6722.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6722.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5378.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6722.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6722.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6722.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12587.37},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6722.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6671.51,"10th_percentile":6671.51,"90th_percentile":6688.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9290.81,"10th_percentile":9290.81,"90th_percentile":14401.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5903.35,"10th_percentile":884.74,"90th_percentile":13154.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8674.73,"10th_percentile":8674.73,"90th_percentile":8674.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6304.82,"10th_percentile":6304.82,"90th_percentile":6545.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc","code_information":[{"code":"564","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9270.8,"maximum":22105.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22105.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11588.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13814.68},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16927.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11588.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20136.1},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11588.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11820.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11588.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11588.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9270.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11588.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11588.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11588.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20893.47},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11588.5,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24593.22,"10th_percentile":24593.22,"90th_percentile":24593.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11266.8,"10th_percentile":11266.8,"90th_percentile":11266.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Musculoskeletal System And Connective Tissue Diagnoses With Cc","code_information":[{"code":"565","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5852.21,"maximum":14500.81,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14500.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7315.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9062.15},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11104.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7315.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13208.87},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7315.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7461.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7315.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7315.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5852.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7315.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7315.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7315.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13705.69},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7315.26,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5572.18,"10th_percentile":5572.18,"90th_percentile":5572.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7138.28,"10th_percentile":7138.28,"90th_percentile":7138.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc","code_information":[{"code":"566","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4500.26,"maximum":10933.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10933.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5625.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6832.75},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8372.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5625.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9959.32},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5625.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5737.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5625.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5625.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4500.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5625.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5625.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5625.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10333.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5625.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Debridement With Mcc","code_information":[{"code":"570","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17664.13,"maximum":42387.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42387.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22080.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26489.64},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32458.82},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22080.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38610.95},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22080.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22521.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22080.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22080.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17664.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22080.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22080.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22080.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40063.22},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22080.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25938.33,"10th_percentile":25938.33,"90th_percentile":25938.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Debridement With Cc","code_information":[{"code":"571","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10147.06,"maximum":24243.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24243.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12683.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15150.84},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18564.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12683.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22083.66},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12683.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12937.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12683.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12683.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10147.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12683.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12683.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12683.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22914.29},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12683.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12551.07,"10th_percentile":12551.07,"90th_percentile":15559.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Debridement Without Cc/Mcc","code_information":[{"code":"572","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6884.63,"maximum":17224.53,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17224.53},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8605.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10764.31},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13189.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8605.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15689.92},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8605.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8777.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8605.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8605.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6884.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8605.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8605.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8605.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16280.06},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8605.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8522.44,"10th_percentile":8522.44,"90th_percentile":8522.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Graft For Skin Ulcer Or Cellulitis With Mcc","code_information":[{"code":"573","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":39347.44,"maximum":94221.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":94221.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49184.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":58882.65},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":72151.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49184.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":85826.58},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49184.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50167.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49184.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49184.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":39347.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":49184.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49184.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49184.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":89054.77},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":49184.3,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Graft For Skin Ulcer Or Cellulitis With Cc","code_information":[{"code":"574","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20849.09,"maximum":52871.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52871.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26061.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":33041.63},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40487.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26061.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48161.05},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26061.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26582.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26061.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26061.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20849.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26061.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26061.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26061.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49972.52},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26061.36,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25793.18,"10th_percentile":25793.18,"90th_percentile":25793.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Graft For Skin Ulcer Or Cellulitis Without Cc/Mcc","code_information":[{"code":"575","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10792.7,"maximum":27858.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27858.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13490.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17409.89},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21333.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13490.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25376.42},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13490.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13760.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13490.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13490.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10792.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13490.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13490.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13490.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26330.9},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13490.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc","code_information":[{"code":"576","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":29436.41,"maximum":73808.81,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73808.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36795.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":46126.15},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56520.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36795.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67232.87},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36795.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37531.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36795.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36795.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29436.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36795.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36795.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36795.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69761.69},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36795.51,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Graft Except For Skin Ulcer Or Cellulitis With Cc","code_information":[{"code":"577","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15919.99,"maximum":41869.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41869.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19899.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26166.26},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32062.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19899.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38139.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19899.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20297.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19899.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19899.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15919.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19899.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19899.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19899.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39574.13},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19899.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/Mcc","code_information":[{"code":"578","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9647.98,"maximum":24755.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24755.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12059.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15470.51},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18956.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12059.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22549.62},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12059.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12301.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12059.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12059.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9647.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12059.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12059.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12059.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23397.77},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12059.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc","code_information":[{"code":"579","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19450.3,"maximum":48169.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48169.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24312.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30103.38},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36886.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24312.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43878.29},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24312.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24799.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24312.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24312.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19450.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24312.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24312.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24312.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45528.68},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24312.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Skin, Subcutaneous Tissue And Breast Procedures With Cc","code_information":[{"code":"580","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10378.3,"maximum":25745.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25745.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12972.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16089.48},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19715.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12972.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23451.82},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12972.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13232.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12972.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12972.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10378.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12972.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12972.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12972.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24333.91},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12972.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16300.62,"10th_percentile":16300.62,"90th_percentile":16300.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/Mcc","code_information":[{"code":"581","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8667.2,"maximum":22768.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22768.34},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10834.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14228.87},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17435.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10834.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20739.81},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10834.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11050.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10834.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10834.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8667.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10834.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10834.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10834.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21519.9},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10834.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":69928.26,"10th_percentile":69928.26,"90th_percentile":69928.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Mastectomy For Malignancy With Cc/Mcc","code_information":[{"code":"582","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11571.08,"maximum":26709.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26709.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14463.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16691.77},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20453.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14463.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24329.71},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14463.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14753.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14463.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14463.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11571.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14463.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14463.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14463.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25244.82},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14463.85,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Mastectomy For Malignancy Without Cc/Mcc","code_information":[{"code":"583","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10356.67,"maximum":26709.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26709.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12945.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16691.77},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20453.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12945.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24329.71},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12945.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13204.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12945.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12945.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10356.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12945.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12945.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12945.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25244.82},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12945.84,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Breast Biopsy, Local Excision And Other Breast Procedures With Cc/Mcc","code_information":[{"code":"584","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12856.95,"maximum":30086.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30086.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16071.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18802.57},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23039.54},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16071.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27406.38},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16071.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16392.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16071.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16071.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12856.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16071.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16071.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16071.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28437.21},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16071.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/Mcc","code_information":[{"code":"585","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11586.1,"maximum":28046.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28046.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14482.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17527.57},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21477.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14482.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25547.95},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14482.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14772.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14482.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14482.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11586.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14482.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14482.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14482.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26508.88},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14482.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13733.02,"10th_percentile":13733.02,"90th_percentile":13733.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":13557.01,"10th_percentile":13557.01,"90th_percentile":13557.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Ulcers With Mcc","code_information":[{"code":"592","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11623.33,"maximum":28318.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28318.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14529.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17697.13},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21685.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14529.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25795.11},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14529.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14819.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14529.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14529.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11623.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14529.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14529.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14529.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26765.34},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14529.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10070.92,"10th_percentile":10070.92,"90th_percentile":10070.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Ulcers With Cc","code_information":[{"code":"593","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7124.87,"maximum":17162.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17162.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8906.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10725.4},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13142.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8906.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15633.2},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8906.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9084.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8906.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8906.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7124.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8906.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8906.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8906.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16221.21},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8906.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8814.12,"10th_percentile":8814.12,"90th_percentile":8814.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Ulcers Without Cc/Mcc","code_information":[{"code":"594","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5205.97,"maximum":11566.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11566.54},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6507.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7228.41},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8857.26},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6507.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10536.03},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6507.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6637.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6507.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6507.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5205.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6507.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6507.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6507.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10932.32},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6507.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Skin Disorders With Mcc","code_information":[{"code":"595","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12736.84,"maximum":29995.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29995.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15921.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18745.12},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22969.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15921.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27322.64},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15921.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16239.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15921.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15921.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12736.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15921.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15921.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15921.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28350.32},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15921.05,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Skin Disorders Without Mcc","code_information":[{"code":"596","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6501.45,"maximum":16409.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16409.04},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10254.68},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12565.47},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14947.09},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8289.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6501.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8126.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15509.29},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8126.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":4225.07,"10th_percentile":4225.07,"90th_percentile":4225.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8025.73,"10th_percentile":8025.73,"90th_percentile":8025.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1792.82,"10th_percentile":1792.82,"90th_percentile":1792.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignant Breast Disorders With Mcc","code_information":[{"code":"597","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10012.54,"maximum":25776.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25776.74},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12515.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16108.94},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19738.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12515.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23480.18},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12515.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12765.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12515.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12515.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10012.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12515.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12515.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12515.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24363.34},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12515.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignant Breast Disorders With Cc","code_information":[{"code":"598","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6794.54,"maximum":16245.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16245.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8493.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10152.76},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12440.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8493.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14798.52},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8493.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8663.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8493.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8493.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6794.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8493.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8493.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8493.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15355.14},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8493.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignant Breast Disorders Without Cc/Mcc","code_information":[{"code":"599","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4620.98,"maximum":10267.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10267.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5776.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6416.71},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7862.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5776.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9352.91},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5776.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5891.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5776.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5776.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4620.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5776.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5776.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5776.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9704.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5776.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Malignant Breast Disorders With Cc/Mcc","code_information":[{"code":"600","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6255.81,"maximum":14784.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14784.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7819.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9239.13},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11321.07},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7819.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13466.83},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7819.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7976.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7819.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7819.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6255.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7819.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7819.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7819.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13973.36},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7819.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":782.92,"10th_percentile":782.92,"90th_percentile":782.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Malignant Breast Disorders Without Cc/Mcc","code_information":[{"code":"601","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3633.61,"maximum":8916.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8916.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4542.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5572.57},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6828.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4542.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8122.51},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4542.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4632.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4542.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4542.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3633.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4542.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4542.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4542.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8428.02},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4542.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13.39,"10th_percentile":13.39,"90th_percentile":13.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2750.0,"10th_percentile":2750.0,"90th_percentile":2750.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cellulitis With Mcc","code_information":[{"code":"602","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8536.27,"maximum":21161.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21161.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10670.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13224.44},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16204.43},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10670.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19275.76},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10670.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10883.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10670.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10670.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8536.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10670.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10670.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10670.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20000.78},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10670.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10572.42,"10th_percentile":10572.42,"90th_percentile":10572.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":60416.7,"10th_percentile":60416.7,"90th_percentile":60416.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10550.61,"10th_percentile":10549.62,"90th_percentile":11946.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10336.0,"10th_percentile":10336.0,"90th_percentile":10336.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cellulitis Without Mcc","code_information":[{"code":"603","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5230.59,"maximum":12800.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12800.15},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6538.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7999.34},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9801.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6538.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11659.73},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6538.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6669.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6538.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6538.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5230.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6538.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6538.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6538.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12098.29},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6538.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":42239.68,"10th_percentile":42239.68,"90th_percentile":42239.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6474.67,"10th_percentile":6464.81,"90th_percentile":6504.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"13","median_amount":9035.59,"10th_percentile":6877.2,"90th_percentile":16417.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12828.17,"10th_percentile":12828.17,"90th_percentile":12828.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":9217.92,"10th_percentile":4573.88,"90th_percentile":11256.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1803.24,"10th_percentile":1803.24,"90th_percentile":1803.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"25","median_amount":6458.31,"10th_percentile":550.15,"90th_percentile":6491.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":338.44,"10th_percentile":338.44,"90th_percentile":338.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":12360.68,"10th_percentile":12360.68,"90th_percentile":12998.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"21","median_amount":6346.9,"10th_percentile":1650.0,"90th_percentile":6363.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc","code_information":[{"code":"604","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8841.37,"maximum":21537.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21537.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11051.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13459.79},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16492.82},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11051.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19618.82},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11051.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11272.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11051.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11051.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8841.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11051.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11051.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11051.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20356.74},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11051.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":550.0,"10th_percentile":550.0,"90th_percentile":550.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc","code_information":[{"code":"605","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5501.46,"maximum":13455.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13455.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6876.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8408.9},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10303.76},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6876.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12256.7},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6876.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7014.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6876.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6876.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5501.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6876.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6876.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6876.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12717.71},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6876.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6796.92,"10th_percentile":6796.92,"90th_percentile":6796.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18745.54,"10th_percentile":18745.54,"90th_percentile":18745.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6685.3,"10th_percentile":6685.3,"90th_percentile":6685.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Skin Disorders With Mcc","code_information":[{"code":"606","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9088.22,"maximum":23309.53,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23309.53},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11360.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14567.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17849.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11360.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21232.78},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11360.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11587.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11360.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11360.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9088.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11360.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11360.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11360.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22031.41},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11360.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":10099.47,"10th_percentile":10099.47,"90th_percentile":10099.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Skin Disorders Without Mcc","code_information":[{"code":"607","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5443.8,"maximum":13006.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13006.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6804.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8128.14},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9959.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6804.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11847.46},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6804.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6940.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6804.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6804.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5443.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6804.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6804.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6804.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12293.08},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6804.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":12799.27,"10th_percentile":12799.27,"90th_percentile":12799.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9403.9,"10th_percentile":9403.9,"90th_percentile":9403.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13150.78,"10th_percentile":13150.78,"90th_percentile":13150.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":12171.02,"10th_percentile":12171.02,"90th_percentile":12171.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Adrenal And Pituitary Procedures With Cc/Mcc","code_information":[{"code":"614","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13163.86,"maximum":30104.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30104.74},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16454.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18813.69},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23053.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16454.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27422.58},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16454.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16783.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16454.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16454.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13163.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16454.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16454.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16454.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28454.03},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16454.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":41317.62,"10th_percentile":41317.62,"90th_percentile":41317.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Adrenal And Pituitary Procedures Without Cc/Mcc","code_information":[{"code":"615","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8404.14,"maximum":20181.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20181.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10505.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12611.95},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15453.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10505.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18383.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10505.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10715.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10505.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10505.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8404.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10505.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10505.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10505.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19074.46},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10505.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9572.59,"10th_percentile":9572.59,"90th_percentile":9572.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":18085.95,"10th_percentile":18085.95,"90th_percentile":18085.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":19609.79,"10th_percentile":19609.79,"90th_percentile":19609.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Mcc Or Insertion Of","code_information":[{"code":"616","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20945.18,"maximum":46633.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46633.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26181.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29143.42},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35710.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26181.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42479.07},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26181.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26705.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26181.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26181.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20945.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26181.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26181.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26181.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44076.83},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26181.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25858.2,"10th_percentile":25858.2,"90th_percentile":25858.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":46476.58,"10th_percentile":46476.58,"90th_percentile":46476.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Cc","code_information":[{"code":"617","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11232.94,"maximum":25542.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25542.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14041.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15962.54},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19559.54},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14041.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23266.79},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14041.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14322.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14041.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14041.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11232.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14041.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14041.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14041.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24141.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14041.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28770.97,"10th_percentile":28770.97,"90th_percentile":28770.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14682.2,"10th_percentile":14682.2,"90th_percentile":14682.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":24925.49,"10th_percentile":24925.49,"90th_percentile":24925.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc","code_information":[{"code":"618","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8518.25,"maximum":18926.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18926.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10647.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11828.05},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14493.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10647.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17240.41},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10647.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10860.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10647.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10647.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8518.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10647.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10647.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10647.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17888.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10647.81,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. Procedures For Obesity With Mcc","code_information":[{"code":"619","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17341.61,"maximum":38530.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38530.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21677.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24079.55},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29505.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21677.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35098.04},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21677.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22110.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21677.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21677.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17341.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21677.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21677.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21677.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36418.18},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21677.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. Procedures For Obesity With Cc","code_information":[{"code":"620","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9611.34,"maximum":23487.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23487.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12014.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14678.27},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17985.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12014.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21394.85},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12014.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12254.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12014.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12014.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9611.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12014.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12014.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12014.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22199.58},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12014.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. Procedures For Obesity Without Cc/Mcc","code_information":[{"code":"621","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9059.39,"maximum":23176.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23176.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11324.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14483.68},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17747.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11324.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21111.23},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11324.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11550.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11324.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11324.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9059.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11324.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11324.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11324.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21905.28},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11324.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Mcc","code_information":[{"code":"622","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":21376.41,"maximum":56142.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56142.44},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26720.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35085.71},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42991.92},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26720.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51140.47},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26720.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27254.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26720.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26720.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21376.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26720.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26720.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26720.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53064.01},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26720.51,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18442.73,"10th_percentile":18442.73,"90th_percentile":18442.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25872.23,"10th_percentile":25872.23,"90th_percentile":25872.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Cc","code_information":[{"code":"623","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10774.09,"maximum":29705.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29705.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13467.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18564.43},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22747.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13467.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27059.27},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13467.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13736.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13467.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13467.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10774.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13467.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13467.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13467.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28077.05},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13467.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25563.08,"10th_percentile":25563.08,"90th_percentile":25563.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12796.02,"10th_percentile":12796.02,"90th_percentile":12796.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc","code_information":[{"code":"624","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7518.86,"maximum":19991.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19991.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9398.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12493.35},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15308.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9398.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18210.14},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9398.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9586.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9398.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9398.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7518.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9398.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9398.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9398.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18895.08},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9398.57,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Thyroid, Parathyroid And Thyroglossal Procedures With Mcc","code_information":[{"code":"625","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18138.59,"maximum":46005.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46005.22},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22673.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28750.54},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35229.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22673.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41906.42},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22673.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23126.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22673.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22673.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18138.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22673.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22673.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22673.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43482.64},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22673.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":43036.43,"10th_percentile":43036.43,"90th_percentile":43036.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Thyroid, Parathyroid And Thyroglossal Procedures With Cc","code_information":[{"code":"626","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9005.34,"maximum":23017.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23017.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11256.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14384.54},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17625.95},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11256.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20966.71},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11256.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11481.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11256.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11256.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9005.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11256.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11256.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11256.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21755.33},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11256.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Thyroid, Parathyroid And Thyroglossal Procedures Without Cc/Mcc","code_information":[{"code":"627","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7977.71,"maximum":19761.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19761.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9972.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12349.72},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15132.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9972.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18000.8},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9972.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10171.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9972.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9972.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7977.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9972.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9972.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9972.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18677.86},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9972.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18678.28,"10th_percentile":18678.28,"90th_percentile":18678.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Mcc Or Insertion Of Antibiotic-Eluti","code_information":[{"code":"628","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22383.01,"maximum":54894.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54894.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27978.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34305.51},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42035.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27978.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50003.26},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27978.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28538.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27978.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27978.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22383.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27978.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27978.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27978.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51884.03},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27978.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":27645.33,"10th_percentile":27645.33,"90th_percentile":27645.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Cc","code_information":[{"code":"629","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13085.78,"maximum":31778.71,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31778.71},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16357.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19859.82},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24335.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16357.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28947.41},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16357.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16684.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16357.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16357.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13085.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16357.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16357.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16357.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30036.21},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16357.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28687.36,"10th_percentile":28687.36,"90th_percentile":28687.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16204.28,"10th_percentile":16204.28,"90th_percentile":16204.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Endocrine, Nutritional And Metabolic O.R. Procedures Without Cc/Mcc","code_information":[{"code":"630","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8765.7,"maximum":20335.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20335.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10957.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12708.32},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15572.01},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10957.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18523.48},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10957.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11176.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10957.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10957.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8765.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10957.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10957.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10957.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19220.2},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10957.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Diabetes With Mcc","code_information":[{"code":"637","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8628.76,"maximum":20946.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20946.1},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13090.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16039.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19079.93},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11001.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8628.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10785.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19797.58},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10785.95,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10652.79,"10th_percentile":10652.79,"90th_percentile":10652.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12631.93,"10th_percentile":12631.93,"90th_percentile":16990.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10665.79,"10th_percentile":10663.79,"90th_percentile":20446.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2041.76,"10th_percentile":2041.76,"90th_percentile":2041.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":13375.79,"10th_percentile":13375.79,"90th_percentile":13375.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8032.7,"10th_percentile":8032.7,"90th_percentile":8052.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Diabetes With Cc","code_information":[{"code":"638","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5382.54,"maximum":13370.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13370.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6728.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8356.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10239.04},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6728.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12179.71},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6728.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6862.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6728.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6728.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5382.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6728.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6728.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6728.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12637.83},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6728.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":9164.11,"10th_percentile":9164.11,"90th_percentile":9164.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4615.63,"10th_percentile":4615.63,"90th_percentile":6644.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9298.08,"10th_percentile":4822.3,"90th_percentile":9515.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":11583.39,"10th_percentile":11583.39,"90th_percentile":11583.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6657.11,"10th_percentile":6644.48,"90th_percentile":6686.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":59.59,"10th_percentile":59.59,"90th_percentile":59.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":12559.35,"10th_percentile":11485.35,"90th_percentile":13375.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":274.59,"10th_percentile":274.59,"90th_percentile":6514.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Diabetes Without Cc/Mcc","code_information":[{"code":"639","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3730.9,"maximum":9452.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9452.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4663.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5907.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7238.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4663.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8610.08},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4663.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4756.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4663.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4663.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3730.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4663.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4663.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4663.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8933.93},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4663.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":9210.53,"10th_percentile":9210.53,"90th_percentile":9210.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8852.1,"10th_percentile":8852.1,"90th_percentile":8852.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3764.17,"10th_percentile":3764.17,"90th_percentile":3764.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4876.55,"10th_percentile":4876.55,"90th_percentile":4876.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":800.0,"10th_percentile":800.0,"90th_percentile":800.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":280.99,"10th_percentile":280.99,"90th_percentile":280.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With Mcc","code_information":[{"code":"640","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8021.56,"maximum":19856.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19856.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10026.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12409.03},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15205.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10026.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18087.24},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10026.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10227.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10026.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10026.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8021.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10026.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10026.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10026.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18767.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10026.95,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9923.17,"10th_percentile":9923.17,"90th_percentile":9923.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16923.57,"10th_percentile":11426.91,"90th_percentile":72824.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9552.81,"10th_percentile":9552.81,"90th_percentile":9748.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"14","median_amount":9903.42,"10th_percentile":5769.62,"90th_percentile":9942.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":689.79,"10th_percentile":689.79,"90th_percentile":689.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":18576.83,"10th_percentile":18576.83,"90th_percentile":18576.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9612.48,"10th_percentile":125.0,"90th_percentile":9763.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Without Mcc","code_information":[{"code":"641","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4673.84,"maximum":11659.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11659.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5842.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7286.78},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8928.79},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5842.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10621.12},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5842.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5959.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5842.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5842.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4673.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5842.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5842.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5842.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11020.61},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5842.3,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5770.17,"10th_percentile":5770.17,"90th_percentile":5817.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"14","median_amount":10271.62,"10th_percentile":8073.83,"90th_percentile":12430.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5497.34,"10th_percentile":5497.34,"90th_percentile":5497.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":2792.0,"10th_percentile":2135.0,"90th_percentile":10058.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2121.63,"10th_percentile":2121.63,"90th_percentile":2121.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"16","median_amount":5770.82,"10th_percentile":1200.0,"90th_percentile":5797.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2536.68,"10th_percentile":2536.68,"90th_percentile":3701.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":11614.64,"10th_percentile":11614.64,"90th_percentile":11614.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":5657.04,"10th_percentile":150.0,"90th_percentile":5678.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inborn And Other Disorders Of Metabolism","code_information":[{"code":"642","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8541.07,"maximum":19610.19,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19610.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12255.21},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15016.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17863.04},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10889.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8541.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10676.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18534.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10676.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12790.29,"10th_percentile":12790.29,"90th_percentile":12790.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endocrine Disorders With Mcc","code_information":[{"code":"643","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9886.41,"maximum":23927.81,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23927.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14953.47},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18323.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21795.98},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12605.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9886.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12358.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22615.79},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12358.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":23244.58,"10th_percentile":23244.58,"90th_percentile":23244.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23456.93,"10th_percentile":23456.93,"90th_percentile":23456.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10413.83,"10th_percentile":10413.83,"90th_percentile":10413.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":21275.84,"10th_percentile":21275.84,"90th_percentile":21275.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12204.29,"10th_percentile":12204.29,"90th_percentile":12205.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7346.97,"10th_percentile":7346.97,"90th_percentile":7346.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endocrine Disorders With Cc","code_information":[{"code":"644","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6156.1,"maximum":14892.24,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14892.24},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7695.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9306.77},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11403.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7695.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13565.43},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7695.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7849.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7695.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7695.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6156.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7695.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7695.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7695.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14075.66},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7695.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":11391.58,"10th_percentile":11391.58,"90th_percentile":11391.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12968.14,"10th_percentile":10634.38,"90th_percentile":14725.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7605.41,"10th_percentile":7605.41,"90th_percentile":7648.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7495.11,"10th_percentile":7495.11,"90th_percentile":7495.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endocrine Disorders Without Cc/Mcc","code_information":[{"code":"645","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4614.38,"maximum":11062.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11062.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5767.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6913.36},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8471.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5767.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10076.83},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5767.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5883.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5767.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5767.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4614.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5767.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5767.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5767.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10455.85},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5767.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5696.76,"10th_percentile":5696.76,"90th_percentile":5696.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":11466.88,"10th_percentile":11466.88,"90th_percentile":11466.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney Transplant With Hemodialysis With Mcc","code_information":[{"code":"650","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28236.42,"maximum":69569.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69569.77},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35295.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43477.0},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53274.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35295.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63371.5},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35295.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36001.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35295.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35295.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28236.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35295.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35295.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35295.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65755.09},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35295.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney Transplant With Hemodialysis Without Mcc","code_information":[{"code":"651","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22256.88,"maximum":55866.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55866.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27821.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34913.36},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42780.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27821.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50889.26},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27821.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28377.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27821.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27821.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22256.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27821.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27821.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27821.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52803.35},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27821.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney Transplant","code_information":[{"code":"652","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19396.24,"maximum":47140.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47140.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24245.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29460.32},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36098.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24245.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42940.98},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24245.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24730.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24245.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24245.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19396.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24245.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24245.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24245.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44556.11},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24245.3,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Bladder Procedures With Mcc","code_information":[{"code":"653","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":31209.36,"maximum":77312.43,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77312.43},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":48315.7},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59203.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70424.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39791.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31209.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39011.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73073.2},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39011.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Bladder Procedures With Cc","code_information":[{"code":"654","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16812.48,"maximum":41806.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41806.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21015.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26126.41},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32013.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21015.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38081.52},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21015.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21435.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21015.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21015.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16812.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21015.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21015.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21015.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39513.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21015.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":39890.03,"10th_percentile":39890.03,"90th_percentile":39890.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Bladder Procedures Without Cc/Mcc","code_information":[{"code":"655","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12712.22,"maximum":30459.11,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30459.11},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15890.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19035.14},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23324.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15890.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27745.38},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15890.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16208.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15890.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15890.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12712.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15890.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15890.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15890.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28788.96},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15890.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Ureter Procedures For Neoplasm With Mcc","code_information":[{"code":"656","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19121.77,"maximum":48605.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48605.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23902.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30375.8},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37220.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23902.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44275.37},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23902.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24380.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23902.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23902.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19121.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23902.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23902.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23902.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45940.69},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23902.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23161.51,"10th_percentile":23161.51,"90th_percentile":23161.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23606.1,"10th_percentile":23606.1,"90th_percentile":23606.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Ureter Procedures For Neoplasm With Cc","code_information":[{"code":"657","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10990.9,"maximum":27229.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27229.79},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13738.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17017.01},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20851.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13738.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24803.77},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13738.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14013.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13738.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13738.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10990.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13738.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13738.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13738.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25736.71},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13738.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26050.43,"10th_percentile":26050.43,"90th_percentile":26050.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":23652.75,"10th_percentile":23652.75,"90th_percentile":23652.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":25618.99,"10th_percentile":25618.99,"90th_percentile":25618.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Ureter Procedures For Neoplasm Without Cc/Mcc","code_information":[{"code":"658","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9320.05,"maximum":22821.72,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22821.72},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11650.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14262.23},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17476.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11650.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20788.44},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11650.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11883.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11650.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11650.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9320.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11650.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11650.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11650.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21570.35},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11650.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":21912.97,"10th_percentile":21912.97,"90th_percentile":21912.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11516.75,"10th_percentile":11516.75,"90th_percentile":11516.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22113.15,"10th_percentile":22113.15,"90th_percentile":22113.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":16345.11,"10th_percentile":16345.11,"90th_percentile":16345.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11519.14,"10th_percentile":11519.14,"90th_percentile":11519.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11301.76,"10th_percentile":11301.76,"90th_percentile":11301.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Ureter Procedures For Non-Neoplasm With Mcc","code_information":[{"code":"659","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15260.54,"maximum":36176.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36176.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19075.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22608.11},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27702.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19075.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32953.29},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19075.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19457.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19075.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19075.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15260.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19075.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19075.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19075.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34192.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19075.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26361.84,"10th_percentile":26361.84,"90th_percentile":26361.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18838.39,"10th_percentile":18838.39,"90th_percentile":18862.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":86799.77,"10th_percentile":86799.77,"90th_percentile":86799.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Ureter Procedures For Non-Neoplasm With Cc","code_information":[{"code":"660","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7938.07,"maximum":19300.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19300.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9922.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12061.55},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14779.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9922.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17580.76},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9922.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10121.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9922.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9922.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7938.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9922.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9922.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9922.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18242.02},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9922.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":18663.73,"10th_percentile":18663.73,"90th_percentile":18663.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5795.58,"10th_percentile":5795.58,"90th_percentile":5795.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22721.57,"10th_percentile":18346.34,"90th_percentile":62216.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":17082.97,"10th_percentile":17082.97,"90th_percentile":17082.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9815.16,"10th_percentile":9800.76,"90th_percentile":9999.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2505.06,"10th_percentile":2505.06,"90th_percentile":2505.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":17498.3,"10th_percentile":17498.3,"90th_percentile":19726.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9629.93,"10th_percentile":280.69,"90th_percentile":9640.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Ureter Procedures For Non-Neoplasm Without Cc/Mcc","code_information":[{"code":"661","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6218.57,"maximum":15474.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15474.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7773.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9670.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11850.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7773.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14096.21},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7773.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7928.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7773.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7773.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6218.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7773.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7773.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7773.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14626.41},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7773.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7684.43,"10th_percentile":790.0,"90th_percentile":7693.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":14754.45,"10th_percentile":12418.4,"90th_percentile":46915.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":10093.75,"10th_percentile":1712.29,"90th_percentile":13382.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2424.2,"10th_percentile":2424.2,"90th_percentile":2424.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7697.53,"10th_percentile":7697.53,"90th_percentile":7697.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":14510.1,"10th_percentile":14510.1,"90th_percentile":14510.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7568.43,"10th_percentile":7568.43,"90th_percentile":7568.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Bladder Procedures With Mcc","code_information":[{"code":"662","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18387.24,"maximum":45204.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45204.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22984.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28250.18},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34616.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22984.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41177.09},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22984.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23443.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22984.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22984.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18387.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22984.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22984.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22984.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42725.88},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22984.05,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Bladder Procedures With Cc","code_information":[{"code":"663","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9130.26,"maximum":22646.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22646.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11412.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14152.89},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17342.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11412.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20629.06},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11412.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11641.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11412.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11412.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9130.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11412.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11412.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11412.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21404.98},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11412.82,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":65235.5,"10th_percentile":65235.5,"90th_percentile":65235.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Minor Bladder Procedures Without Cc/Mcc","code_information":[{"code":"664","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6287.64,"maximum":15491.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15491.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7859.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9681.12},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11862.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7859.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14111.07},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7859.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8016.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7859.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7859.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6287.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7859.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7859.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7859.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14641.83},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7859.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Prostatectomy With Mcc","code_information":[{"code":"665","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18745.8,"maximum":48209.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48209.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23432.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30128.4},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36917.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23432.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43914.76},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23432.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23900.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23432.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23432.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18745.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23432.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23432.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23432.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45566.52},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23432.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Prostatectomy With Cc","code_information":[{"code":"666","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10506.22,"maximum":26764.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26764.22},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13132.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16726.06},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20495.11},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13132.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24379.68},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13132.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13395.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13132.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13132.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10506.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13132.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13132.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13132.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25296.67},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13132.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Prostatectomy Without Cc/Mcc","code_information":[{"code":"667","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6643.79,"maximum":16761.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16761.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8304.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10475.21},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12835.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8304.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15268.53},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8304.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8470.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8304.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8304.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6643.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8304.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8304.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8304.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15842.83},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8304.74,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Transurethral Procedures With Mcc","code_information":[{"code":"668","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17537.4,"maximum":42581.66,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42581.66},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21921.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26611.03},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32607.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21921.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38787.88},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21921.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22360.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21921.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21921.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17537.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21921.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21921.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21921.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40246.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21921.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21670.06,"10th_percentile":21670.06,"90th_percentile":21670.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Transurethral Procedures With Cc","code_information":[{"code":"669","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9321.25,"maximum":23096.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23096.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11651.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14433.65},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17686.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11651.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21038.3},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11651.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11884.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11651.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11651.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9321.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11651.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11651.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11651.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21829.61},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11651.56,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7262.25,"10th_percentile":7262.25,"90th_percentile":7262.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":29256.75,"10th_percentile":29256.75,"90th_percentile":29256.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10894.06,"10th_percentile":10894.06,"90th_percentile":10894.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11534.63,"10th_percentile":11534.63,"90th_percentile":11534.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11511.24,"10th_percentile":11511.24,"90th_percentile":11511.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Transurethral Procedures Without Cc/Mcc","code_information":[{"code":"670","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5869.62,"maximum":15273.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15273.29},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7337.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9544.91},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11695.76},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7337.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13912.53},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7337.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7483.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7337.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7337.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5869.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7337.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7337.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7337.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14435.82},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7337.03,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":7290.37,"10th_percentile":7290.37,"90th_percentile":7290.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7246.45,"10th_percentile":7246.45,"90th_percentile":7246.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Urethral Procedures With Cc/Mcc","code_information":[{"code":"671","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10780.7,"maximum":29186.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29186.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13475.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18240.12},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22350.35},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13475.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26586.56},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13475.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13745.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13475.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13475.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10780.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13475.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13475.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13475.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27586.56},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13475.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Urethral Procedures Without Cc/Mcc","code_information":[{"code":"672","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6483.43,"maximum":14405.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14405.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8104.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9002.85},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11031.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8104.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13122.43},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8104.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8266.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8104.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8104.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6483.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8104.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8104.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8104.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13616.0},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8104.29,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Kidney And Urinary Tract Procedures With Mcc","code_information":[{"code":"673","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25234.64,"maximum":63048.85,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63048.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31543.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39401.81},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48280.61},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31543.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57431.56},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31543.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32174.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31543.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31543.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25234.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31543.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31543.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31543.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59591.73},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31543.3,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2257.42,"10th_percentile":2257.42,"90th_percentile":2257.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":31206.93,"10th_percentile":31206.93,"90th_percentile":31206.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Kidney And Urinary Tract Procedures With Cc","code_information":[{"code":"674","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14045.54,"maximum":33366.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33366.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17556.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20852.21},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25551.04},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17556.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30393.9},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17556.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17908.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17556.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17556.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14045.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17556.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17556.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17556.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31537.11},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17556.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":43515.65,"10th_percentile":43515.65,"90th_percentile":43515.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":16069.26,"10th_percentile":16069.26,"90th_percentile":16069.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17366.53,"10th_percentile":17346.16,"90th_percentile":17387.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Kidney And Urinary Tract Procedures Without Cc/Mcc","code_information":[{"code":"675","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9858.18,"maximum":23560.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23560.1},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12322.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14723.67},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18041.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12322.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21461.03},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12322.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12569.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12322.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12322.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9858.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12322.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12322.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12322.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22268.25},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12322.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Renal Failure With Mcc","code_information":[{"code":"682","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8894.82,"maximum":21734.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21734.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11118.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13583.03},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16643.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11118.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19798.45},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11118.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11340.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11118.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11118.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8894.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11118.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11118.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11118.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20543.12},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11118.53,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":41.87,"10th_percentile":41.87,"90th_percentile":41.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":21104.25,"10th_percentile":21104.25,"90th_percentile":21104.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13426.93,"10th_percentile":13426.93,"90th_percentile":13426.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":11730.27,"10th_percentile":11730.27,"90th_percentile":11730.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6568.05,"10th_percentile":4450.67,"90th_percentile":10992.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":280.59,"10th_percentile":280.59,"90th_percentile":10764.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Renal Failure With Cc","code_information":[{"code":"683","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5260.02,"maximum":12822.39,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12822.39},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6575.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8013.24},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9818.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6575.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11679.99},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6575.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6706.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6575.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6575.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5260.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6575.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6575.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6575.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12119.31},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6575.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6493.23,"10th_percentile":2710.89,"90th_percentile":6525.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":9086.43,"10th_percentile":6480.15,"90th_percentile":12480.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6183.99,"10th_percentile":6183.99,"90th_percentile":6183.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":11319.72,"10th_percentile":11319.72,"90th_percentile":11319.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":6503.23,"10th_percentile":6493.23,"90th_percentile":6529.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":565.74,"10th_percentile":565.74,"90th_percentile":790.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":12273.46,"10th_percentile":12273.46,"90th_percentile":12273.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6387.92,"10th_percentile":6237.33,"90th_percentile":6410.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Renal Failure Without Cc/Mcc","code_information":[{"code":"684","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3605.38,"maximum":8902.13,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8902.13},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4506.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5563.31},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6816.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4506.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8109.0},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4506.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4596.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4506.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4506.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3605.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4506.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4506.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4506.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8414.01},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4506.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6079.28,"10th_percentile":6079.28,"90th_percentile":6079.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":8959.48,"10th_percentile":8959.48,"90th_percentile":8959.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Neoplasms With Mcc","code_information":[{"code":"686","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10832.94,"maximum":25569.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25569.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13541.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15979.22},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19579.97},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13541.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23291.1},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13541.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13812.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13541.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13541.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10832.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13541.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13541.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13541.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24167.14},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13541.18,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Neoplasms With Cc","code_information":[{"code":"687","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6293.04,"maximum":14751.38,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14751.38},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7866.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9218.74},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11296.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7866.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13437.12},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7866.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8023.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7866.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7866.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6293.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7866.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7866.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7866.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13942.53},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7866.3,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":15638.42,"10th_percentile":15638.42,"90th_percentile":15638.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Neoplasms Without Cc/Mcc","code_information":[{"code":"688","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4746.51,"maximum":10871.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10871.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5933.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6793.83},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8324.75},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5933.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9902.6},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5933.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6051.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5933.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5933.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4746.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5933.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5933.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5933.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10275.06},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5933.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Infections With Mcc","code_information":[{"code":"689","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6968.71,"maximum":16925.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16925.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8710.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10577.14},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12960.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8710.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15417.1},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8710.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8885.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8710.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8710.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6968.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8710.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8710.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8710.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15996.98},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8710.89,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6001.69,"10th_percentile":6001.69,"90th_percentile":8602.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7698.28,"10th_percentile":7698.28,"90th_percentile":7698.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":14746.88,"10th_percentile":14746.88,"90th_percentile":14746.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"17","median_amount":8447.06,"10th_percentile":1104.63,"90th_percentile":8629.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":8478.66,"10th_percentile":8478.66,"90th_percentile":8478.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8435.16,"10th_percentile":8434.66,"90th_percentile":8488.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Infections Without Mcc","code_information":[{"code":"690","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4861.82,"maximum":11873.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11873.46},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6077.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7420.21},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9092.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6077.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10815.6},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6077.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6198.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6077.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6077.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4861.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6077.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6077.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6077.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11222.41},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6077.28,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":15690.16,"10th_percentile":15690.16,"90th_percentile":15690.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6002.25,"10th_percentile":4438.86,"90th_percentile":6049.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":11473.92,"10th_percentile":9539.23,"90th_percentile":15259.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5683.02,"10th_percentile":5138.58,"90th_percentile":5908.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":2792.0,"10th_percentile":2135.0,"90th_percentile":10462.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3807.69,"10th_percentile":3807.69,"90th_percentile":3807.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"18","median_amount":6002.25,"10th_percentile":80.0,"90th_percentile":6050.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":108.87,"10th_percentile":108.87,"90th_percentile":457.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1951.29,"10th_percentile":1951.29,"90th_percentile":1951.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":1357.0,"10th_percentile":130.0,"90th_percentile":12081.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"17","median_amount":5884.56,"10th_percentile":150.0,"90th_percentile":5928.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Urinary Stones With Mcc","code_information":[{"code":"693","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8075.01,"maximum":19504.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19504.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10093.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12189.42},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14936.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10093.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17767.14},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10093.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10295.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10093.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10093.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8075.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10093.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10093.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10093.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18435.42},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10093.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10004.2,"10th_percentile":10004.2,"90th_percentile":10004.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":18841.82,"10th_percentile":18841.82,"90th_percentile":18841.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Urinary Stones Without Mcc","code_information":[{"code":"694","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4694.86,"maximum":11587.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11587.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5868.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7241.38},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8873.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5868.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10554.94},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5868.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5985.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5868.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5868.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4694.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5868.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5868.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5868.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10951.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5868.57,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":375.0,"10th_percentile":375.0,"90th_percentile":375.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11134.95,"10th_percentile":9273.12,"90th_percentile":14216.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":6586.92,"10th_percentile":6586.92,"90th_percentile":10085.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22391.32,"10th_percentile":22391.32,"90th_percentile":22391.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":11666.87,"10th_percentile":11666.87,"90th_percentile":11666.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":130.0,"10th_percentile":130.0,"90th_percentile":130.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Signs And Symptoms With Mcc","code_information":[{"code":"695","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6869.62,"maximum":16511.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16511.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8587.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10318.62},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12643.81},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8587.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15040.28},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8587.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8758.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8587.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8587.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6869.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8587.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8587.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8587.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15605.99},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8587.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11866.93,"10th_percentile":11866.93,"90th_percentile":11866.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Kidney And Urinary Tract Signs And Symptoms Without Mcc","code_information":[{"code":"696","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4138.1,"maximum":9899.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9899.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6186.91},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7581.07},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9017.96},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5276.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4138.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5172.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9357.15},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5172.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5138.78,"10th_percentile":5138.78,"90th_percentile":5138.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":8399.0,"10th_percentile":8399.0,"90th_percentile":8399.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5040.71,"10th_percentile":5040.71,"90th_percentile":5040.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Urethral Stricture","code_information":[{"code":"697","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6473.22,"maximum":14382.19,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14382.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8091.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8988.02},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11013.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8091.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13100.82},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8091.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8253.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8091.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8091.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6473.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8091.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8091.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8091.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13593.58},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8091.53,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11380.58,"10th_percentile":11380.58,"90th_percentile":11380.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8465.72,"10th_percentile":8465.72,"90th_percentile":8465.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Kidney And Urinary Tract Diagnoses With Mcc","code_information":[{"code":"698","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9936.26,"maximum":24316.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24316.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12420.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15196.24},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18620.56},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12420.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22149.84},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12420.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12668.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12420.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12420.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9936.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12420.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12420.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12420.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22982.96},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12420.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7544.3,"10th_percentile":2370.0,"90th_percentile":12313.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10530.63,"10th_percentile":10530.63,"90th_percentile":10530.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9781.21,"10th_percentile":9781.21,"90th_percentile":9781.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":21383.12,"10th_percentile":21133.12,"90th_percentile":21383.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10242.11,"10th_percentile":7054.95,"90th_percentile":12268.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":23184.76,"10th_percentile":23184.76,"90th_percentile":23184.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12036.0,"10th_percentile":278.49,"90th_percentile":12080.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Kidney And Urinary Tract Diagnoses With Cc","code_information":[{"code":"699","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6096.05,"maximum":14829.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14829.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7620.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9267.85},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11356.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7620.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13508.7},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7620.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7772.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7620.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7620.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6096.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7620.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7620.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7620.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14016.8},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7620.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7525.98,"10th_percentile":5114.97,"90th_percentile":7543.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14036.67,"10th_percentile":13148.4,"90th_percentile":49151.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6733.53,"10th_percentile":6733.53,"90th_percentile":6801.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":11109.88,"10th_percentile":11109.88,"90th_percentile":11109.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7560.27,"10th_percentile":7525.27,"90th_percentile":7566.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1069.84,"10th_percentile":1069.84,"90th_percentile":1069.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":14224.21,"10th_percentile":14224.21,"90th_percentile":14224.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7411.42,"10th_percentile":7411.42,"90th_percentile":7420.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Kidney And Urinary Tract Diagnoses Without Cc/Mcc","code_information":[{"code":"700","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4143.51,"maximum":9993.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9993.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5179.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6245.28},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7652.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5179.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9103.04},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5179.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5282.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5179.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5179.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4143.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5179.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5179.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5179.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9445.44},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5179.39,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5114.97,"10th_percentile":5114.97,"90th_percentile":5114.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":8347.7,"10th_percentile":8347.7,"90th_percentile":8347.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2099.35,"10th_percentile":2099.35,"90th_percentile":2099.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":10296.76,"10th_percentile":10296.76,"90th_percentile":10296.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Male Pelvic Procedures With Cc/Mcc","code_information":[{"code":"707","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12013.72,"maximum":30340.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30340.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15017.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18961.02},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23233.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15017.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27637.33},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15017.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15317.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15017.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15017.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12013.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15017.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15017.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15017.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28676.85},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15017.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14862.35,"10th_percentile":14862.35,"90th_percentile":14862.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Male Pelvic Procedures Without Cc/Mcc","code_information":[{"code":"708","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9214.34,"maximum":22412.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22412.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11517.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14006.49},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17162.71},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11517.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20415.67},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11517.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11748.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11517.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11517.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9214.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11517.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11517.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11517.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21183.56},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11517.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":21664.44,"10th_percentile":21664.44,"90th_percentile":21664.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12917.33,"10th_percentile":12917.33,"90th_percentile":12917.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Penis Procedures With Cc/Mcc","code_information":[{"code":"709","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13976.46,"maximum":31053.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31053.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17470.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19406.71},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23779.82},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17470.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28286.97},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17470.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17819.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17470.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17470.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13976.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17470.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17470.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17470.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29350.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17470.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Penis Procedures Without Cc/Mcc","code_information":[{"code":"710","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8415.55,"maximum":22510.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22510.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10519.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14067.64},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17237.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10519.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20504.81},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10519.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10729.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10519.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10519.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8415.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10519.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10519.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10519.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21276.05},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10519.44,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Testes Procedures With Cc/Mcc","code_information":[{"code":"711","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12515.22,"maximum":28963.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28963.06},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15644.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18100.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22178.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15644.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26382.62},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15644.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15956.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15644.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15644.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12515.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15644.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15644.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15644.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27374.95},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15644.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Testes Procedures Without Cc/Mcc","code_information":[{"code":"712","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6604.75,"maximum":16025.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16025.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8255.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10014.69},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12271.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8255.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14597.28},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8255.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8421.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8255.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8255.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6604.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8255.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8255.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8255.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15146.33},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8255.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Transurethral Prostatectomy With Cc/Mcc","code_information":[{"code":"713","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9029.36,"maximum":22949.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22949.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11286.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14341.91},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17573.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11286.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20904.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11286.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11512.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11286.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11286.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9029.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11286.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11286.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11286.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21690.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11286.7,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10587.35,"10th_percentile":10587.35,"90th_percentile":10587.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11168.05,"10th_percentile":11168.05,"90th_percentile":11168.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Transurethral Prostatectomy Without Cc/Mcc","code_information":[{"code":"714","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6350.7,"maximum":17148.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17148.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7938.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10717.06},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13132.04},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7938.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15621.04},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7938.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8097.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7938.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7938.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6350.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7938.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7938.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7938.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16208.59},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7938.38,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2710.89,"10th_percentile":2710.89,"90th_percentile":2710.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7840.83,"10th_percentile":7840.83,"90th_percentile":7840.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Male Reproductive System And Other O.R. Procedures For Malignancy With Cc/Mcc","code_information":[{"code":"715","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13437.13,"maximum":33947.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33947.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16796.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21215.43},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25996.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16796.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30923.34},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16796.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17132.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16796.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16796.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13437.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16796.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16796.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16796.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32086.45},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16796.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Male Reproductive System And Other O.R. Procedures For Malignancy Without Cc/Mcc","code_information":[{"code":"716","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8834.77,"maximum":21665.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21665.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11043.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13539.48},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16590.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11043.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19734.97},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11043.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11264.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11043.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11043.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8834.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11043.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11043.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11043.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20477.26},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11043.46,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Male Reproductive System O.R. Procedures With Cc/Mcc","code_information":[{"code":"717","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11354.26,"maximum":28998.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28998.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18122.44},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22206.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26415.03},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14476.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11354.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27408.58},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26413.22,"10th_percentile":26413.22,"90th_percentile":26413.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Male Reproductive System O.R. Procedures Without Cc/Mcc","code_information":[{"code":"718","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8066.6,"maximum":19693.22,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19693.22},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10083.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12307.1},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15080.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10083.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17938.67},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10083.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10284.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10083.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10083.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8066.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10083.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10083.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10083.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18613.39},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10083.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":5625.89,"10th_percentile":5625.89,"90th_percentile":5625.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy, Male Reproductive System With Mcc","code_information":[{"code":"722","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10868.98,"maximum":24734.4,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24734.4},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13586.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15457.54},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18940.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13586.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22530.71},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13586.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13857.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13586.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13586.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10868.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13586.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13586.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13586.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23378.15},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13586.23,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":23090.37,"10th_percentile":23090.37,"90th_percentile":23090.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy, Male Reproductive System With Cc","code_information":[{"code":"723","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6863.01,"maximum":15854.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15854.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8578.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9908.13},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12140.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8578.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14441.97},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8578.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8750.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8578.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8578.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6863.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8578.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8578.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8578.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14985.17},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8578.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy, Male Reproductive System Without Cc/Mcc","code_information":[{"code":"724","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3938.1,"maximum":8749.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8749.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4922.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5467.87},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6700.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4922.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7969.89},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4922.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5021.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4922.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4922.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3938.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4922.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4922.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4922.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8269.66},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4922.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11008.19,"10th_percentile":11008.19,"90th_percentile":11008.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Benign Prostatic Hypertrophy With Mcc","code_information":[{"code":"725","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7028.18,"maximum":17159.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17159.29},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8785.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10723.54},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13139.98},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8785.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15630.49},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8785.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8960.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8785.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8785.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7028.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8785.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8785.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8785.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16218.4},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8785.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8312.66,"10th_percentile":8312.66,"90th_percentile":8312.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8534.46,"10th_percentile":8534.46,"90th_percentile":8534.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Benign Prostatic Hypertrophy Without Mcc","code_information":[{"code":"726","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4336.3,"maximum":10748.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10748.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5420.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6716.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8230.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5420.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9790.5},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5420.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5528.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5420.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5420.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4336.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5420.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5420.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5420.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10158.75},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5420.38,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5353.46,"10th_percentile":5353.46,"90th_percentile":5353.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":776.54,"10th_percentile":776.54,"90th_percentile":776.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inflammation Of The Male Reproductive System With Mcc","code_information":[{"code":"727","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8906.24,"maximum":20304.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20304.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11132.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12688.86},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15548.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11132.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18495.12},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11132.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11355.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11132.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11132.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8906.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11132.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11132.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11132.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19190.77},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11132.8,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inflammation Of The Male Reproductive System Without Mcc","code_information":[{"code":"728","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4872.03,"maximum":12187.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12187.79},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6090.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7616.65},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9332.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6090.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11101.93},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6090.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6211.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6090.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6090.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4872.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6090.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6090.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6090.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11519.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6090.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6024.29,"10th_percentile":6024.29,"90th_percentile":6024.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4609.93,"10th_percentile":4609.93,"90th_percentile":4609.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":7692.76,"10th_percentile":7692.76,"90th_percentile":7692.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6049.86,"10th_percentile":6049.86,"90th_percentile":6049.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Male Reproductive System Diagnoses With Cc/Mcc","code_information":[{"code":"729","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6358.51,"maximum":15646.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15646.93},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9778.41},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11981.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14252.88},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8107.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6358.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7948.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14788.97},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7948.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Male Reproductive System Diagnoses Without Cc/Mcc","code_information":[{"code":"730","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4036.01,"maximum":9778.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9778.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5045.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6110.93},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7487.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5045.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8907.21},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5045.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5145.91,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5045.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5045.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4036.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5045.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5045.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5045.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9242.23},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5045.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12861.06,"10th_percentile":12861.06,"90th_percentile":12861.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":9417.41,"10th_percentile":9417.41,"90th_percentile":9417.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Malignancy With Mcc","code_information":[{"code":"731","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32859.09,"maximum":52579.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52579.51},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32859.09},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40263.55},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47894.98},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49696.45}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Malignancy With Cc","code_information":[{"code":"732","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17790.72,"maximum":28467.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28467.84},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17790.72},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21799.68},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25931.52},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26906.88}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Malignancy Without Cc/Mcc","code_information":[{"code":"733","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13267.06,"maximum":21229.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21229.3},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13267.06},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16256.66},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19337.89},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20065.25}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc","code_information":[{"code":"734","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12792.7,"maximum":28423.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28423.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15990.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17762.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21765.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15990.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25891.0},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15990.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16310.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15990.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15990.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12792.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15990.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15990.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15990.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26864.84},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15990.87,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/Mcc","code_information":[{"code":"735","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8081.02,"maximum":17955.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17955.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10101.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11221.13},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13749.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10101.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16355.77},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10101.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10303.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10101.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10101.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8081.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10101.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10101.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10101.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16970.95},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10101.27,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Non-Malignancy With Cc/Mcc","code_information":[{"code":"742","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11019.74,"maximum":27352.85,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27352.85},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13774.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17093.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20945.86},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13774.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24915.87},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13774.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14050.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13774.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13774.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11019.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13774.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13774.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13774.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25853.03},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13774.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25176.04,"10th_percentile":23590.58,"90th_percentile":26145.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":28060.87,"10th_percentile":28060.87,"90th_percentile":28060.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13627.33,"10th_percentile":13627.33,"90th_percentile":13627.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":27384.39,"10th_percentile":25599.37,"90th_percentile":27384.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13397.35,"10th_percentile":13397.35,"90th_percentile":13397.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc","code_information":[{"code":"743","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7451.59,"maximum":19229.14,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19229.14},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9314.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12017.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14725.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9314.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17515.93},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9314.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9500.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9314.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9314.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7451.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9314.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9314.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9314.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18174.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9314.49,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":16926.84,"10th_percentile":16926.84,"90th_percentile":16926.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15682.71,"10th_percentile":9310.82,"90th_percentile":21232.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":15261.61,"10th_percentile":15261.61,"90th_percentile":15261.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4025.48,"10th_percentile":4025.48,"90th_percentile":4025.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":17387.17,"10th_percentile":17387.17,"90th_percentile":17387.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"D&C, Conization, Laparoscopy And Tubal Interruption With Cc/Mcc","code_information":[{"code":"744","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12306.81,"maximum":30574.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30574.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15383.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19107.42},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23413.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15383.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27850.72},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15383.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15691.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15383.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15383.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12306.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15383.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15383.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15383.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28898.27},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15383.51,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"D&C, Conization, Laparoscopy And Tubal Interruption Without Cc/Mcc","code_information":[{"code":"745","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6831.78,"maximum":15798.17,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15798.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8539.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9872.92},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12097.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8539.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14390.64},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8539.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8710.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8539.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8539.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6831.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8539.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8539.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8539.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14931.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8539.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vagina, Cervix And Vulva Procedures With Cc/Mcc","code_information":[{"code":"746","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10432.95,"maximum":24093.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24093.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13041.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15057.25},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18450.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13041.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21947.25},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13041.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13302.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13041.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13041.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10432.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13041.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13041.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13041.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22772.75},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13041.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24053.68,"10th_percentile":24053.68,"90th_percentile":24053.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":16432.28,"10th_percentile":16432.28,"90th_percentile":16432.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12880.97,"10th_percentile":12880.97,"90th_percentile":12880.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12640.84,"10th_percentile":12640.84,"90th_percentile":12640.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vagina, Cervix And Vulva Procedures Without Cc/Mcc","code_information":[{"code":"747","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5163.32,"maximum":12856.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12856.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6454.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8034.55},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9845.05},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6454.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11711.05},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6454.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6583.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6454.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6454.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5163.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6454.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6454.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6454.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12151.54},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6454.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Female Reproductive System Reconstructive Procedures","code_information":[{"code":"748","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8332.06,"maximum":20467.19,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20467.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10415.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12790.79},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15673.06},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10415.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18643.68},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10415.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10623.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10415.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10415.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8332.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10415.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10415.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10415.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19344.93},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10415.08,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Female Reproductive System O.R. Procedures With Cc/Mcc","code_information":[{"code":"749","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15420.9,"maximum":36631.59,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36631.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19276.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22892.58},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28051.19},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19276.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33367.92},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19276.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19661.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19276.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19276.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15420.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19276.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19276.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19276.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34622.99},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19276.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Female Reproductive System O.R. Procedures Without Cc/Mcc","code_information":[{"code":"750","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8863.59,"maximum":22158.95,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22158.95},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11079.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13848.04},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16968.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11079.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20184.72},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11079.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11301.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11079.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11079.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8863.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11079.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11079.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11079.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20943.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11079.49,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy, Female Reproductive System With Mcc","code_information":[{"code":"754","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11061.18,"maximum":26805.73,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26805.73},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13826.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16752.0},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20526.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13826.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24417.5},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13826.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14103.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13826.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13826.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11061.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13826.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13826.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13826.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25335.91},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13826.47,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13674.47,"10th_percentile":13674.47,"90th_percentile":13674.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy, Female Reproductive System With Cc","code_information":[{"code":"755","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6533.28,"maximum":17030.29,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17030.29},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8166.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10642.93},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13041.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8166.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15512.99},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8166.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8329.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8166.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8166.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6533.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8166.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8166.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8166.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16096.48},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8166.6,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8065.03,"10th_percentile":8065.03,"90th_percentile":8065.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15501.15,"10th_percentile":15501.15,"90th_percentile":15501.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8085.02,"10th_percentile":8085.02,"90th_percentile":8085.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Malignancy, Female Reproductive System Without Cc/Mcc","code_information":[{"code":"756","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5768.72,"maximum":12817.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12817.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7210.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8010.46},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9815.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7210.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11675.94},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7210.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7355.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7210.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7210.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5768.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7210.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7210.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7210.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12115.1},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7210.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Infections, Female Reproductive System With Mcc","code_information":[{"code":"757","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8599.94,"maximum":21711.18,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21711.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10749.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13568.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16625.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10749.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19776.84},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10749.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10964.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10749.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10749.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8599.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10749.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10749.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10749.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20520.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10749.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Infections, Female Reproductive System With Cc","code_information":[{"code":"758","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5879.83,"maximum":14683.18,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14683.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7349.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9176.12},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11243.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7349.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13374.99},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7349.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7496.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7349.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7349.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5879.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7349.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7349.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7349.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13878.06},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7349.79,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18382.84,"10th_percentile":18382.84,"90th_percentile":18382.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Infections, Female Reproductive System Without Cc/Mcc","code_information":[{"code":"759","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3985.55,"maximum":11397.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11397.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4981.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7122.77},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8727.82},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4981.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10382.06},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4981.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5081.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4981.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4981.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3985.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4981.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4981.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4981.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10772.56},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4981.94,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":6275.19,"10th_percentile":6275.19,"90th_percentile":6275.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2009.15,"10th_percentile":2009.15,"90th_percentile":2009.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Menstrual And Other Female Reproductive System Disorders With Cc/Mcc","code_information":[{"code":"760","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6051.0,"maximum":15012.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15012.34},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7563.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9381.83},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11495.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7563.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13674.83},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7563.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7715.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7563.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7563.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6051.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7563.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7563.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7563.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14189.18},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7563.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":1357.0,"10th_percentile":1357.0,"90th_percentile":1357.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Menstrual And Other Female Reproductive System Disorders Without Cc/Mcc","code_information":[{"code":"761","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3426.4,"maximum":10436.73,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10436.73},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4283.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6522.34},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7992.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4283.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9506.87},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4283.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4368.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4283.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4283.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3426.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4283.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4283.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4283.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9864.45},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4283.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery With O.R. Procedures Except Sterilization And/Or D&C","code_information":[{"code":"768","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6435.98,"maximum":15577.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15577.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8044.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9734.86},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11928.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8044.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14189.4},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8044.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8205.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8044.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8044.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6435.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8044.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8044.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8044.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14723.11},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8044.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":7973.0,"10th_percentile":7973.0,"90th_percentile":9192.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":9917.85,"10th_percentile":8894.28,"90th_percentile":16502.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":5609.0,"10th_percentile":4487.19,"90th_percentile":9926.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2095.27,"10th_percentile":1841.33,"90th_percentile":6947.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2095.27,"10th_percentile":2095.27,"90th_percentile":2095.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":9116.0,"10th_percentile":8559.97,"90th_percentile":10494.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postpartum And Post Abortion Diagnoses With O.R. Procedures","code_information":[{"code":"769","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10148.87,"maximum":24710.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24710.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12686.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15442.72},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18922.58},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12686.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22509.1},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12686.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12939.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12686.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12686.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10148.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12686.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12686.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12686.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23355.73},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12686.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Abortion With D&C, Aspiration Curettage Or Hysterotomy","code_information":[{"code":"770","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6022.18,"maximum":16290.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16290.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7527.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10180.55},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12474.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7527.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14839.04},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7527.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7678.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7527.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7527.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6022.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7527.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7527.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7527.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15397.18},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7527.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9903.01,"10th_percentile":9903.01,"90th_percentile":9903.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":14965.3,"10th_percentile":14965.3,"90th_percentile":14965.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postpartum And Post Abortion Diagnoses Without O.R. Procedures","code_information":[{"code":"776","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3932.1,"maximum":9960.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9960.78},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4915.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6224.9},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7627.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4915.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9073.33},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4915.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5013.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4915.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4915.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3932.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4915.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4915.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4915.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9414.61},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4915.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":9245.02,"10th_percentile":9245.02,"90th_percentile":9245.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8173.54,"10th_percentile":6004.9,"90th_percentile":12041.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":7962.0,"10th_percentile":6806.7,"90th_percentile":8462.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1475.72,"10th_percentile":1475.72,"90th_percentile":1475.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2423.16,"10th_percentile":2423.16,"90th_percentile":2423.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":8821.5,"10th_percentile":8821.5,"90th_percentile":8821.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Abortion Without D&C","code_information":[{"code":"779","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5052.82,"maximum":15120.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15120.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6316.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9449.47},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11578.81},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6316.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13773.42},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6316.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6442.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6316.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6316.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5052.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6316.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6316.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6316.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14291.48},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6316.02,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":11789.98,"10th_percentile":11789.98,"90th_percentile":11789.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cesarean Section With Sterilization With Mcc","code_information":[{"code":"783","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14745.23,"maximum":33323.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33323.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18431.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20825.34},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25518.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18431.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30354.74},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18431.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18800.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18431.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18431.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14745.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18431.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18431.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18431.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31496.47},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18431.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":9322.0,"10th_percentile":9322.0,"90th_percentile":9322.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cesarean Section With Sterilization With Cc","code_information":[{"code":"784","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6366.92,"maximum":15491.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15491.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7958.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9681.12},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11862.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7958.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14111.07},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7958.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8117.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7958.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7958.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6366.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7958.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7958.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7958.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14641.83},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7958.65,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12051.64,"10th_percentile":12051.64,"90th_percentile":12051.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":5740.0,"10th_percentile":5740.0,"90th_percentile":5740.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3100.84,"10th_percentile":3100.84,"90th_percentile":3100.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3100.84,"10th_percentile":3100.84,"90th_percentile":3100.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":9928.0,"10th_percentile":9928.0,"90th_percentile":9928.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cesarean Section With Sterilization Without Cc/Mcc","code_information":[{"code":"785","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5752.5,"maximum":13001.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13001.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7190.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8125.36},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9956.32},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7190.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11843.41},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7190.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7334.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7190.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7190.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5752.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7190.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7190.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7190.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12288.88},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7190.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":9326.0,"10th_percentile":9326.0,"90th_percentile":9326.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"21","median_amount":9718.92,"10th_percentile":6212.18,"90th_percentile":12648.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"14","median_amount":8226.0,"10th_percentile":6980.8,"90th_percentile":8726.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3100.84,"10th_percentile":3100.84,"90th_percentile":4046.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":9928.0,"10th_percentile":9322.0,"90th_percentile":11306.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cesarean Section Without Sterilization With Mcc","code_information":[{"code":"786","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9906.83,"maximum":24270.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24270.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12383.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15167.52},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18585.36},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12383.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22107.97},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12383.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12631.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12383.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12383.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9906.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12383.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12383.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12383.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22939.52},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12383.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":9326.0,"10th_percentile":9326.0,"90th_percentile":9326.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20490.18,"10th_percentile":15316.56,"90th_percentile":31070.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3948.85,"10th_percentile":3948.85,"90th_percentile":3948.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3948.85,"10th_percentile":3948.85,"90th_percentile":3948.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cesarean Section Without Sterilization With Cc","code_information":[{"code":"787","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6707.46,"maximum":16115.47,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16115.47},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10071.22},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12340.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14679.67},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8552.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6707.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15231.82},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8384.32,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":12524.0,"10th_percentile":12524.0,"90th_percentile":12524.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"22","median_amount":14660.85,"10th_percentile":9201.44,"90th_percentile":20702.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"15","median_amount":7726.0,"10th_percentile":5740.0,"90th_percentile":8726.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3090.14,"10th_percentile":3090.14,"90th_percentile":3090.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3090.14,"10th_percentile":3090.14,"90th_percentile":3948.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"13","median_amount":9322.0,"10th_percentile":9322.0,"90th_percentile":9928.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cesarean Section Without Sterilization Without Cc/Mcc","code_information":[{"code":"788","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5758.51,"maximum":13532.6,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13532.6},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7198.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8457.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10362.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7198.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12326.93},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7198.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7342.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7198.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7198.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5758.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7198.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7198.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7198.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12790.58},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7198.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"21","median_amount":9326.0,"10th_percentile":8160.0,"90th_percentile":11367.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5213.72,"10th_percentile":5213.72,"90th_percentile":5213.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"128","median_amount":11613.46,"10th_percentile":6471.06,"90th_percentile":16530.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"66","median_amount":7726.0,"10th_percentile":5124.75,"90th_percentile":8726.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":22118.0,"10th_percentile":22118.0,"90th_percentile":22118.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"12","median_amount":3090.14,"10th_percentile":3090.14,"90th_percentile":3948.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3090.14,"10th_percentile":3090.14,"90th_percentile":3090.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"43","median_amount":3090.14,"10th_percentile":3090.14,"90th_percentile":3948.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"65","median_amount":9928.0,"10th_percentile":9322.0,"90th_percentile":11306.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9322.0,"10th_percentile":9322.0,"90th_percentile":9322.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Neonates, Died Or Transferred To Another Acute Care Facility","code_information":[{"code":"789","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10823.94,"maximum":27038.52,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27038.52},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13529.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16897.48},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20705.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13529.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24629.54},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13529.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13800.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13529.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13529.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10823.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13529.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13529.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13529.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25555.93},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13529.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":593.55,"10th_percentile":593.55,"90th_percentile":593.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extreme Immaturity Or Respiratory Distress Syndrome, Neonate","code_information":[{"code":"790","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":35696.42,"maximum":89172.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":89172.54},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44620.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":55727.58},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":68285.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44620.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81227.79},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44620.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45512.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44620.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44620.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35696.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":44620.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44620.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44620.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":84283.0},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44620.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":71054.13,"10th_percentile":48197.03,"90th_percentile":181212.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":25114.0,"10th_percentile":25114.0,"90th_percentile":25114.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2718.15,"10th_percentile":2718.15,"90th_percentile":18245.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":6644.0,"10th_percentile":6644.0,"90th_percentile":6644.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Prematurity With Major Problems","code_information":[{"code":"791","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":24378.18,"maximum":60898.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60898.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30472.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":38058.24},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46634.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30472.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55473.19},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30472.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31082.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30472.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30472.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":24378.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30472.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30472.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30472.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57559.7},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30472.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":3983.2,"10th_percentile":3983.2,"90th_percentile":3983.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2877.52,"10th_percentile":1765.35,"90th_percentile":13962.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2877.52,"10th_percentile":2877.52,"90th_percentile":2877.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Prematurity Without Major Problems","code_information":[{"code":"792","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14709.79,"maximum":36745.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36745.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18387.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22963.93},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28138.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18387.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33471.92},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18387.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18754.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18387.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18387.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14709.79,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18387.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18387.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18387.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34730.9},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18387.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":42739.87,"10th_percentile":42739.87,"90th_percentile":42739.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"12","median_amount":2008.79,"10th_percentile":1339.19,"90th_percentile":19568.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":826.59,"10th_percentile":826.59,"90th_percentile":826.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12591.96,"10th_percentile":12591.96,"90th_percentile":12600.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":882.68,"10th_percentile":593.55,"90th_percentile":898.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":7337.0,"10th_percentile":7337.0,"90th_percentile":7337.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Full Term Neonate With Major Problems","code_information":[{"code":"793","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25042.45,"maximum":62558.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62558.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31303.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39095.11},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47904.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31303.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56984.52},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31303.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31929.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31303.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31303.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25042.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31303.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31303.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31303.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":59127.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31303.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":5979.0,"10th_percentile":1674.0,"90th_percentile":49525.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6745.79,"10th_percentile":6745.79,"90th_percentile":6745.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1951.29,"10th_percentile":1386.75,"90th_percentile":20479.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":2340.0,"10th_percentile":2340.0,"90th_percentile":2340.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Neonate With Other Significant Problems","code_information":[{"code":"794","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8864.19,"maximum":22142.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22142.64},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11080.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13837.84},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16956.06},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11080.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20169.86},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11080.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11301.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11080.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11080.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8864.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11080.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11080.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11080.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20928.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11080.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16439.09,"10th_percentile":16439.09,"90th_percentile":20531.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"31","median_amount":1483.18,"10th_percentile":517.5,"90th_percentile":3067.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"19","median_amount":882.68,"10th_percentile":593.55,"90th_percentile":2877.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":593.55,"10th_percentile":593.55,"90th_percentile":882.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"33","median_amount":882.68,"10th_percentile":593.55,"90th_percentile":2877.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"12","median_amount":3111.0,"10th_percentile":2198.0,"90th_percentile":7814.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Normal Newborn","code_information":[{"code":"795","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":1199.99,"maximum":2998.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":2998.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1499.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":1873.59},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":2295.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1499.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":2730.91},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1499.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1529.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1499.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1499.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":1199.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":1499.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1499.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1499.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":2833.63},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":1499.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":1540.0,"10th_percentile":1540.0,"90th_percentile":1540.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"13","median_amount":2562.45,"10th_percentile":2277.72,"90th_percentile":3389.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"157","median_amount":1339.21,"10th_percentile":585.9,"90th_percentile":1674.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"43","median_amount":593.55,"10th_percentile":593.55,"90th_percentile":593.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"22","median_amount":593.55,"10th_percentile":593.55,"90th_percentile":826.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"146","median_amount":593.55,"10th_percentile":593.55,"90th_percentile":593.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"51","median_amount":2198.0,"10th_percentile":1170.0,"90th_percentile":3297.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery With Sterilization And/Or D&C With Mcc","code_information":[{"code":"796","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7008.95,"maximum":17509.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17509.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8761.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10942.22},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13407.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8761.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15949.24},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8761.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8936.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8761.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8761.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7008.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8761.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8761.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8761.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16549.13},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8761.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery With Sterilization And/Or D&C With Cc","code_information":[{"code":"797","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6008.36,"maximum":14534.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14534.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7510.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9083.46},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11130.33},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7510.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13239.93},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7510.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7660.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7510.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7510.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6008.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7510.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7510.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7510.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13737.92},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7510.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":7994.0,"10th_percentile":7994.0,"90th_percentile":7994.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8303.32,"10th_percentile":8303.32,"90th_percentile":8303.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":6481.59,"10th_percentile":6481.59,"90th_percentile":6481.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery With Sterilization And/Or D&C Without Cc/Mcc","code_information":[{"code":"798","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5748.3,"maximum":13709.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13709.04},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7185.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8567.34},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10497.91},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7185.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12487.65},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7185.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7329.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7185.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7185.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5748.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7185.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7185.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7185.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12957.34},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7185.38,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7074.48,"10th_percentile":7074.48,"90th_percentile":7074.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":9116.0,"10th_percentile":9116.0,"90th_percentile":9116.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Splenic Procedures With Mcc","code_information":[{"code":"799","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27200.38,"maximum":71848.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":71848.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34000.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":44901.18},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55019.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34000.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":65447.37},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34000.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34680.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34000.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34000.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27200.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34000.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34000.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34000.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":67909.04},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34000.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Splenic Procedures With Cc","code_information":[{"code":"800","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16873.14,"maximum":46687.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46687.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21091.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29176.78},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35751.48},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21091.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42527.69},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21091.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21513.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21091.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21091.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16873.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21091.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21091.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21091.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44127.28},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21091.43,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Splenic Procedures Without Cc/Mcc","code_information":[{"code":"801","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11464.78,"maximum":32512.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32512.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14330.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20318.48},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24897.05},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14330.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29615.96},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14330.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14617.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14330.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14330.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11464.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14330.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14330.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14330.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30729.9},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14330.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures Of The Blood And Blood Forming Organs With Mcc","code_information":[{"code":"802","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23928.34,"maximum":54862.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54862.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29910.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34286.05},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42012.07},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29910.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49974.9},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29910.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":30508.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29910.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29910.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23928.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29910.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29910.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29910.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51854.6},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29910.43,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures Of The Blood And Blood Forming Organs Without Cc/Mcc","code_information":[{"code":"804","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8144.08,"maximum":21081.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21081.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10180.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13174.4},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16143.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10180.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19202.83},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10180.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10383.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10180.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10180.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8144.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10180.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10180.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10180.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19925.11},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10180.1,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery Without Sterilization Or D&C With Mcc","code_information":[{"code":"805","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6481.63,"maximum":16755.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16755.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8102.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10471.51},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12831.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8102.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15263.13},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8102.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8264.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8102.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8102.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6481.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8102.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8102.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8102.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15837.22},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8102.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12397.21,"10th_percentile":12397.21,"90th_percentile":15378.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":8102.0,"10th_percentile":8102.0,"90th_percentile":8102.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":7266.0,"10th_percentile":4105.66,"90th_percentile":9854.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery Without Sterilization Or D&C With Cc","code_information":[{"code":"806","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4528.5,"maximum":11697.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11697.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5660.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7309.95},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8957.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5660.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10654.88},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5660.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5773.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5660.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5660.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4528.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5660.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5660.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5660.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11055.64},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5660.62,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":7973.0,"10th_percentile":7593.0,"90th_percentile":12586.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"33","median_amount":6995.6,"10th_percentile":3622.75,"90th_percentile":13863.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"21","median_amount":6109.0,"10th_percentile":3003.05,"90th_percentile":9085.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2133.01,"10th_percentile":2133.01,"90th_percentile":2133.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"15","median_amount":2133.01,"10th_percentile":2133.01,"90th_percentile":4655.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"13","median_amount":8560.0,"10th_percentile":7266.0,"90th_percentile":10494.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Vaginal Delivery Without Sterilization Or D&C Without Cc/Mcc","code_information":[{"code":"807","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4049.22,"maximum":10085.33,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10085.33},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5061.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6302.73},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7722.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5061.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9186.78},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5061.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5162.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5061.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5061.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4049.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5061.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5061.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5061.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9532.32},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5061.52,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"63","median_amount":7973.0,"10th_percentile":7593.0,"90th_percentile":9192.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"1 through 10","median_amount":19632.44,"10th_percentile":19632.44,"90th_percentile":19632.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"250","median_amount":7844.45,"10th_percentile":3607.35,"90th_percentile":12168.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"204","median_amount":5024.0,"10th_percentile":2516.3,"90th_percentile":7952.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"102","median_amount":1841.33,"10th_percentile":1841.33,"90th_percentile":2133.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"135","median_amount":7738.0,"10th_percentile":7266.0,"90th_percentile":9116.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":31212.58,"10th_percentile":31212.58,"90th_percentile":31212.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16370.31,"10th_percentile":16370.31,"90th_percentile":16370.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders ","code_information":[{"code":"809","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7602.94,"maximum":18183.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18183.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9503.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11363.82},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13924.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9503.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16563.76},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9503.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9693.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9503.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9503.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7602.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9503.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9503.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9503.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17186.77},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9503.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17789.08,"10th_percentile":17789.08,"90th_percentile":17789.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":16007.61,"10th_percentile":15400.75,"90th_percentile":16361.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9415.45,"10th_percentile":9385.45,"90th_percentile":9576.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":18893.56,"10th_percentile":18893.56,"90th_percentile":18893.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders ","code_information":[{"code":"810","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6285.84,"maximum":15937.54,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15937.54},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7857.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9960.02},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12204.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7857.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14517.6},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7857.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8014.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7857.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7857.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6285.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7857.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7857.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7857.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15063.65},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7857.3,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":916.54,"10th_percentile":916.54,"90th_percentile":7759.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Red Blood Cell Disorders With Mcc","code_information":[{"code":"811","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8434.17,"maximum":20744.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20744.46},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10542.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12964.06},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15885.38},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10542.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18896.24},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10542.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10753.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10542.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10542.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8434.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10542.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10542.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10542.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19606.99},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10542.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6811.79,"10th_percentile":6811.79,"90th_percentile":6811.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14569.61,"10th_percentile":12769.61,"90th_percentile":15038.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":18150.58,"10th_percentile":18150.58,"90th_percentile":18150.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10414.94,"10th_percentile":10411.56,"90th_percentile":10624.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":20959.18,"10th_percentile":20959.18,"90th_percentile":20959.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9952.2,"10th_percentile":9952.2,"90th_percentile":9952.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Red Blood Cell Disorders Without Mcc","code_information":[{"code":"812","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5514.67,"maximum":13695.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13695.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6893.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8559.0},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10487.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6893.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12475.49},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6893.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7031.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6893.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6893.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5514.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6893.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6893.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6893.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12944.73},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6893.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6812.23,"10th_percentile":6807.59,"90th_percentile":6839.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8926.33,"10th_percentile":8326.33,"90th_percentile":9526.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5161.97,"10th_percentile":5161.97,"90th_percentile":5161.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":11367.74,"10th_percentile":11367.74,"90th_percentile":11367.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2944.55,"10th_percentile":2944.55,"90th_percentile":2944.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":6808.23,"10th_percentile":2584.71,"90th_percentile":6825.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":348.05,"10th_percentile":348.05,"90th_percentile":348.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":543.55,"10th_percentile":543.55,"90th_percentile":543.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6715.81,"10th_percentile":6715.81,"90th_percentile":6718.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Coagulation Disorders","code_information":[{"code":"813","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9160.89,"maximum":22654.17,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22654.17},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11451.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14157.52},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17347.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11451.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20635.82},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11451.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11680.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11451.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11451.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9160.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11451.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11451.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11451.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21411.99},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11451.11,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":39797.54,"10th_percentile":39797.54,"90th_percentile":39797.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11315.68,"10th_percentile":11315.68,"90th_percentile":11315.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15824.99,"10th_percentile":15824.99,"90th_percentile":15824.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10362.19,"10th_percentile":10362.19,"90th_percentile":11132.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":2135.0,"10th_percentile":2135.0,"90th_percentile":2135.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11311.44,"10th_percentile":11310.67,"90th_percentile":11340.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":94.08,"10th_percentile":94.08,"90th_percentile":94.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11102.94,"10th_percentile":11102.94,"90th_percentile":11102.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Reticuloendothelial And Immunity Disorders With Mcc","code_information":[{"code":"814","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12772.87,"maximum":30731.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30731.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15966.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19205.64},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23533.44},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15966.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27993.89},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15966.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16285.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15966.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15966.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12772.87,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15966.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15966.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15966.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29046.82},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15966.09,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":2792.0,"10th_percentile":2792.0,"90th_percentile":2792.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15817.99,"10th_percentile":15817.99,"90th_percentile":15817.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Reticuloendothelial And Immunity Disorders With Cc","code_information":[{"code":"815","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6090.04,"maximum":15486.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15486.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7612.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9678.34},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11859.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7612.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14107.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7612.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7764.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7612.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7612.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6090.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7612.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7612.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7612.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14637.62},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7612.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8852.46,"10th_percentile":8852.46,"90th_percentile":8852.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4475.71,"10th_percentile":4475.71,"90th_percentile":4475.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":14210.2,"10th_percentile":14210.2,"90th_percentile":14210.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Reticuloendothelial And Immunity Disorders Without Cc/Mcc","code_information":[{"code":"816","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3795.77,"maximum":10939.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10939.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4744.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6836.45},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8376.98},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4744.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9964.73},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4744.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4839.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4744.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4744.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3795.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4744.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4744.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4744.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10339.53},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4744.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8274.81,"10th_percentile":8274.81,"90th_percentile":8274.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses With O.R. Procedures With Mcc","code_information":[{"code":"817","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13703.19,"maximum":30445.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30445.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17128.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19026.8},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23314.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17128.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27733.22},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17128.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17471.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17128.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17128.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13703.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17128.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17128.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17128.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28776.35},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17128.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":32218.47,"10th_percentile":32218.47,"90th_percentile":32218.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32512.8,"10th_percentile":32512.8,"90th_percentile":32512.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":100.0,"10th_percentile":100.0,"90th_percentile":100.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses With O.R. Procedures With Cc","code_information":[{"code":"818","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6962.1,"maximum":19180.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19180.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8702.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11986.5},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14687.53},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8702.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17471.36},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8702.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8876.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8702.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8702.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6962.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8702.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8702.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8702.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18128.51},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8702.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12178.22,"10th_percentile":12178.22,"90th_percentile":12178.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":12209.85,"10th_percentile":12209.85,"90th_percentile":12209.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":16245.03,"10th_percentile":16245.03,"90th_percentile":16245.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses With O.R. Procedures Without Cc/Mcc","code_information":[{"code":"819","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5164.52,"maximum":11474.62,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11474.62},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6455.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7170.96},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8786.86},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6455.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10452.29},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6455.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6584.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6455.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6455.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5164.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6455.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6455.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6455.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10845.43},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6455.65,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10365.52,"10th_percentile":10365.52,"90th_percentile":10365.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":6557.33,"10th_percentile":6557.33,"90th_percentile":6557.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Leukemia With Major O.R. Procedures With Mcc","code_information":[{"code":"820","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":35223.74,"maximum":92600.55,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":92600.55},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44029.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":57869.88},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70910.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44029.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":84350.37},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44029.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44910.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44029.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44029.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":35223.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":44029.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44029.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44029.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":87523.04},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":44029.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":43537.99,"10th_percentile":43537.99,"90th_percentile":43537.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Leukemia With Major O.R. Procedures With Cc","code_information":[{"code":"821","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13444.94,"maximum":32660.92,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32660.92},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16806.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20411.14},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25010.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16806.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29751.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16806.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17142.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16806.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16806.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13444.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16806.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16806.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16806.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30870.04},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16806.17,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Leukemia With Major O.R. Procedures Without Cc/Mcc","code_information":[{"code":"822","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7231.18,"maximum":16705.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16705.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10440.0},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12792.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15217.21},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9219.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7231.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15789.57},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Non-Acute Leukemia With Other Procedures With Mcc","code_information":[{"code":"823","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27536.12,"maximum":68279.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":68279.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34420.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":42670.86},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52286.31},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34420.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62196.48},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34420.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35108.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34420.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34420.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27536.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34420.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34420.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34420.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64535.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34420.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":83823.0,"10th_percentile":83823.0,"90th_percentile":83823.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33461.51,"10th_percentile":33461.51,"90th_percentile":33461.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Non-Acute Leukemia With Other Procedures With Cc","code_information":[{"code":"824","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13607.1,"maximum":33381.51,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33381.51},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17008.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20861.47},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25562.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17008.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30407.41},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17008.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17349.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17008.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17008.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13607.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17008.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17008.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17008.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31551.12},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17008.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23505.6,"10th_percentile":23505.6,"90th_percentile":23505.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15871.2,"10th_percentile":15871.2,"90th_percentile":15871.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures With Cc","code_information":[{"code":"827","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13880.97,"maximum":35415.77,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35415.77},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17351.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22132.77},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27120.16},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17351.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32260.43},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17351.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17698.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17351.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17351.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13880.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17351.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17351.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17351.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33473.84},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17351.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9780.43,"10th_percentile":9780.43,"90th_percentile":9780.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":87530.94,"10th_percentile":87530.94,"90th_percentile":87530.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19452.09,"10th_percentile":19452.09,"90th_percentile":19452.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16833.98,"10th_percentile":16833.98,"90th_percentile":16833.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures Without C","code_information":[{"code":"828","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10232.95,"maximum":25128.8,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25128.8},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12791.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15704.02},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19242.76},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12791.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22889.97},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12791.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13047.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12791.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12791.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10232.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12791.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12791.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12791.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23750.93},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12791.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20585.52,"10th_percentile":20585.52,"90th_percentile":20585.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedures With Cc/Mcc","code_information":[{"code":"829","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":18978.83,"maximum":46361.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46361.06},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23723.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28972.93},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35501.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23723.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42230.56},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23723.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24198.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23723.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23723.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18978.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23723.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23723.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23723.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43818.98},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23723.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22991.26,"10th_percentile":22991.26,"90th_percentile":22991.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedures Without Cc/Mcc","code_information":[{"code":"830","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9038.97,"maximum":22021.06,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22021.06},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11298.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13761.86},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16862.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11298.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20059.11},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11298.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11524.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11298.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11298.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9038.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11298.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11298.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11298.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20813.59},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11298.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses Without O.R. Procedures With Mcc","code_information":[{"code":"831","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7222.17,"maximum":17129.63,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17129.63},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9027.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10705.01},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13117.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9027.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15603.48},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9027.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9208.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9027.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9027.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7222.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9027.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9027.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9027.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16190.37},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9027.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15456.51,"10th_percentile":15456.51,"90th_percentile":17135.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":7665.93,"10th_percentile":7665.93,"90th_percentile":7665.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2339.53,"10th_percentile":2339.53,"90th_percentile":2339.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses Without O.R. Procedures With Cc","code_information":[{"code":"832","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4333.9,"maximum":11241.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11241.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7025.48},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8608.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10240.25},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5525.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4333.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5417.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10625.41},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5417.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8026.24,"10th_percentile":8026.24,"90th_percentile":8026.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":7266.34,"10th_percentile":7266.34,"90th_percentile":7266.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6231.45,"10th_percentile":6231.45,"90th_percentile":6231.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":10112.5,"10th_percentile":10112.5,"90th_percentile":10112.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Antepartum Diagnoses Without O.R. Procedures Without Cc/Mcc","code_information":[{"code":"833","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3140.51,"maximum":7413.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7413.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3925.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4633.0},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":5677.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3925.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6753.0},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3925.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4004.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3925.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3925.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3140.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":3925.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3925.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3925.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7007.0},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":3925.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":7753.04,"10th_percentile":7753.04,"90th_percentile":7753.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4068.82,"10th_percentile":2640.34,"90th_percentile":9857.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":5507.71,"10th_percentile":2792.0,"90th_percentile":6758.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1613.4,"10th_percentile":1613.4,"90th_percentile":1613.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1613.4,"10th_percentile":1613.4,"90th_percentile":2339.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":7327.92,"10th_percentile":7327.92,"90th_percentile":7804.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2924.0,"10th_percentile":2924.0,"90th_percentile":2924.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Leukemia With Mcc","code_information":[{"code":"834","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":32972.11,"maximum":81662.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81662.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41215.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51034.35},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62534.43},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41215.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74387.0},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41215.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":42039.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41215.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41215.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":32972.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41215.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41215.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41215.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":77184.91},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":41215.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Leukemia With Cc","code_information":[{"code":"835","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12527.23,"maximum":34151.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34151.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15659.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21342.38},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26151.67},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15659.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31108.37},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15659.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15972.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15659.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15659.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12527.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15659.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15659.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15659.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32278.45},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15659.04,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15981.22,"10th_percentile":15981.22,"90th_percentile":15981.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15466.65,"10th_percentile":15466.65,"90th_percentile":15466.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Leukemia Without Cc/Mcc","code_information":[{"code":"836","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7324.26,"maximum":16904.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16904.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9155.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10564.17},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12944.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9155.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15398.19},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9155.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9338.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9155.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9155.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7324.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9155.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9155.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9155.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15977.36},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9155.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12408.97,"10th_percentile":12408.97,"90th_percentile":12408.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9077.31,"10th_percentile":9077.31,"90th_percentile":9077.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemotherapy Agent With Mc","code_information":[{"code":"837","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28854.42,"maximum":69841.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69841.1},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36068.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43646.57},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53481.88},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36068.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":63618.66},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36068.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36789.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36068.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36068.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28854.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36068.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36068.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36068.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66011.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":36068.03,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Chemotherapy Agent","code_information":[{"code":"838","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12536.84,"maximum":31990.74,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31990.74},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15671.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19992.32},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24497.39},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15671.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29140.55},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15671.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15984.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15671.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15671.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12536.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15671.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15671.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15671.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30236.61},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15671.05,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chemotherapy With Acute Leukemia As Secondary Diagnosis Without Cc/Mcc","code_information":[{"code":"839","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8672.0,"maximum":20425.68,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20425.68},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10840.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12764.84},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15641.27},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10840.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18605.87},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10840.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11056.8,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10840.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10840.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8672.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10840.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10840.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10840.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19305.69},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10840.0,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Non-Acute Leukemia With Mcc","code_information":[{"code":"840","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19428.67,"maximum":48539.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":48539.15},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24285.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":30334.1},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37169.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24285.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44214.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24285.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24771.56,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24285.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24285.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19428.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24285.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24285.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24285.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45877.63},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24285.84,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":32427.59,"10th_percentile":32427.59,"90th_percentile":32427.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24032.76,"10th_percentile":24032.76,"90th_percentile":24032.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Non-Acute Leukemia With Cc","code_information":[{"code":"841","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9798.12,"maximum":23377.73,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23377.73},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12247.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14609.7},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17901.85},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12247.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21294.91},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12247.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12492.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12247.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12247.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9798.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12247.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12247.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12247.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22095.87},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12247.65,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2415.0,"10th_percentile":2415.0,"90th_percentile":2415.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12096.45,"10th_percentile":12096.45,"90th_percentile":12096.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11858.15,"10th_percentile":11858.15,"90th_percentile":11858.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Lymphoma And Non-Acute Leukemia Without Cc/Mcc","code_information":[{"code":"842","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6068.42,"maximum":14749.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14749.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7585.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9217.82},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11294.96},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7585.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13435.77},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7585.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7737.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7585.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7585.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6068.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7585.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7585.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7585.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13941.13},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7585.53,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Mcc","code_information":[{"code":"843","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11980.69,"maximum":28841.48,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28841.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14975.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18024.22},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22085.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14975.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26271.87},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14975.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15275.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14975.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14975.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11980.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14975.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14975.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14975.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27260.03},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14975.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Cc","code_information":[{"code":"844","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7311.66,"maximum":18624.19,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18624.19},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9139.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11639.02},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14261.76},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9139.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16964.89},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9139.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9322.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9139.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9139.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7311.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9139.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9139.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9139.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17602.99},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9139.57,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3568.74,"10th_percentile":3568.74,"90th_percentile":3568.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses Without Cc/Mcc","code_information":[{"code":"845","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5114.67,"maximum":12518.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12518.44},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6393.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7823.28},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9586.18},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6393.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11403.12},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6393.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6521.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6393.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6393.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5114.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6393.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6393.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6393.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11832.02},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6393.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc","code_information":[{"code":"846","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15570.45,"maximum":37498.97,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37498.97},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19463.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23434.64},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28715.4},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19463.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34158.02},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19463.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19852.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19463.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19463.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15570.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19463.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19463.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19463.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35442.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19463.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc","code_information":[{"code":"847","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7856.99,"maximum":19992.73,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19992.73},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9821.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12494.27},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15309.73},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9821.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18211.49},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9821.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10017.66,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9821.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9821.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7856.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9821.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9821.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9821.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18896.48},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9821.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9547.71,"10th_percentile":9547.71,"90th_percentile":9547.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Chemotherapy Without Acute Leukemia As Secondary Diagnosis Without Cc/Mcc","code_information":[{"code":"848","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5101.46,"maximum":11493.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11493.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7183.0},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8801.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10469.85},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6504.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5101.46,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6376.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10863.65},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6376.83,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Radiotherapy","code_information":[{"code":"849","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16273.14,"maximum":38321.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38321.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20341.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23948.9},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29345.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20341.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34907.61},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20341.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20748.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20341.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20341.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16273.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20341.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20341.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20341.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36220.58},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20341.43,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Leukemia With Other Procedures","code_information":[{"code":"850","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":52008.6,"maximum":124659.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":124659.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":65010.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":77904.82},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":95459.89},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":65010.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":113553.05},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":65010.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":66310.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":65010.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":65010.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":52008.6,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":65010.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":65010.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":65010.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":117824.11},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":65010.75,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Infectious And Parasitic Diseases With O.R. Procedures With Mcc","code_information":[{"code":"853","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":29661.02,"maximum":73106.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":73106.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37076.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45686.94},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55982.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37076.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66592.68},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37076.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37817.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37076.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37076.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":29661.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37076.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37076.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37076.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":69097.43},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":37076.28,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":35437.72,"10th_percentile":35437.72,"90th_percentile":36649.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":78821.66,"10th_percentile":73692.42,"90th_percentile":219388.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":36047.06,"10th_percentile":36047.06,"90th_percentile":36047.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":62650.45,"10th_percentile":62650.45,"90th_percentile":62650.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"15","median_amount":27929.55,"10th_percentile":15700.75,"90th_percentile":44186.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11119.13,"10th_percentile":11119.13,"90th_percentile":11119.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":25247.13,"10th_percentile":25247.13,"90th_percentile":25247.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":35897.15,"10th_percentile":30936.64,"90th_percentile":35946.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Infectious And Parasitic Diseases With O.R. Procedures With Cc","code_information":[{"code":"854","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12000.5,"maximum":29790.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29790.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15000.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18617.25},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22812.46},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15000.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27136.26},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15000.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15300.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15000.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15000.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12000.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15000.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15000.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15000.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28156.93},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15000.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12844.31,"10th_percentile":12844.31,"90th_percentile":14839.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28472.93,"10th_percentile":28472.93,"90th_percentile":28472.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":12901.03,"10th_percentile":12901.03,"90th_percentile":12901.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14834.03,"10th_percentile":14815.63,"90th_percentile":14857.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":29821.64,"10th_percentile":29821.64,"90th_percentile":29821.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14573.44,"10th_percentile":14573.44,"90th_percentile":14573.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Infectious And Parasitic Diseases With O.R. Procedures Without Cc/Mcc","code_information":[{"code":"855","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8992.12,"maximum":21505.08,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21505.08},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11240.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13439.41},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16467.84},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11240.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19589.1},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11240.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11464.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11240.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11240.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8992.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11240.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11240.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11240.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20325.91},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11240.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14033.45,"10th_percentile":14033.45,"90th_percentile":14033.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postoperative Or Post-Traumatic Infections With O.R. Procedures With Mcc","code_information":[{"code":"856","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":27319.3,"maximum":66457.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66457.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34149.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41532.07},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50890.9},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34149.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60536.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34149.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34832.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34149.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34149.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":27319.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34149.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34149.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34149.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62813.55},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":34149.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":47192.76,"10th_percentile":47192.76,"90th_percentile":47192.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33198.03,"10th_percentile":33198.03,"90th_percentile":41972.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":39478.24,"10th_percentile":39478.24,"90th_percentile":39478.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":35676.75,"10th_percentile":35676.75,"90th_percentile":35676.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":29065.76,"10th_percentile":29065.76,"90th_percentile":29065.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postoperative Or Post-Traumatic Infections With O.R. Procedures With Cc","code_information":[{"code":"857","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12861.76,"maximum":32147.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32147.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16077.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20090.54},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24617.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16077.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29283.71},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16077.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16398.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16077.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16077.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12861.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16077.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16077.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16077.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30385.15},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16077.2,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":30768.25,"10th_percentile":30768.25,"90th_percentile":30768.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15878.71,"10th_percentile":15878.71,"90th_percentile":15878.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22218.06,"10th_percentile":22218.06,"90th_percentile":22218.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15926.22,"10th_percentile":15926.22,"90th_percentile":15926.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9901.28,"10th_percentile":9901.28,"90th_percentile":9901.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":31961.89,"10th_percentile":31961.89,"90th_percentile":31961.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postoperative Or Post-Traumatic Infections With O.R. Procedures Without Cc/Mcc","code_information":[{"code":"858","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8365.7,"maximum":20802.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20802.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10457.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13000.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15929.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10457.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18948.92},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10457.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10666.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10457.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10457.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8365.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10457.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10457.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10457.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19661.64},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10457.12,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":20652.53,"10th_percentile":20652.53,"90th_percentile":20652.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6074.37,"10th_percentile":6074.37,"90th_percentile":6074.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postoperative And Post-Traumatic Infections With Mcc","code_information":[{"code":"862","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10953.06,"maximum":26555.16,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26555.16},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16595.41},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20335.01},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24189.25},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13965.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10953.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25099.07},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13691.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":23571.32,"10th_percentile":23571.32,"90th_percentile":23571.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13553.02,"10th_percentile":13541.02,"90th_percentile":13577.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13310.91,"10th_percentile":13310.91,"90th_percentile":13310.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Postoperative And Post-Traumatic Infections Without Mcc","code_information":[{"code":"863","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5993.34,"maximum":14631.28,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14631.28},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7491.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9143.69},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11204.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7491.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13327.72},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7491.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7641.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7491.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7491.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5993.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7491.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7491.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7491.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13829.02},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7491.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2710.89,"10th_percentile":2710.89,"90th_percentile":2710.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14220.08,"10th_percentile":10353.21,"90th_percentile":57009.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":10510.88,"10th_percentile":10510.88,"90th_percentile":10510.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":23240.71,"10th_percentile":23240.71,"90th_percentile":23240.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":16361.72,"10th_percentile":16361.72,"90th_percentile":16361.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7287.11,"10th_percentile":7287.11,"90th_percentile":7309.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Fever And Inflammatory Conditions","code_information":[{"code":"864","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5331.49,"maximum":12681.53,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12681.53},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6664.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7925.21},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9711.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6664.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11551.68},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6664.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6797.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6664.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6664.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5331.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6664.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6664.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6664.36,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11986.17},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6664.36,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6597.89,"10th_percentile":6597.89,"90th_percentile":6597.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12342.19,"10th_percentile":12342.19,"90th_percentile":12342.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":6625.98,"10th_percentile":6625.98,"90th_percentile":9350.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6582.09,"10th_percentile":6582.09,"90th_percentile":6582.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6464.04,"10th_percentile":6464.04,"90th_percentile":6486.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Viral Illness With Mcc","code_information":[{"code":"865","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8998.73,"maximum":19994.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19994.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11248.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12495.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15310.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11248.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18212.84},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11248.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11473.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11248.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11248.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8998.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11248.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11248.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11248.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18897.88},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11248.41,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Viral Illness Without Mcc","code_information":[{"code":"866","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5222.78,"maximum":12886.15,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12886.15},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6528.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8053.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9867.76},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6528.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11738.06},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6528.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6659.05,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6528.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6528.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5222.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6528.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6528.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6528.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12179.57},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6528.48,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7513.48,"10th_percentile":7513.48,"90th_percentile":7513.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7052.72,"10th_percentile":7052.72,"90th_percentile":7052.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":799.88,"10th_percentile":799.88,"90th_percentile":799.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":12186.57,"10th_percentile":12186.57,"90th_percentile":12186.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Infectious And Parasitic Diseases Diagnoses With Mcc","code_information":[{"code":"867","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12571.67,"maximum":32404.41,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32404.41},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15714.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20250.84},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24814.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15714.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29517.36},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15714.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16028.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15714.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15714.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12571.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15714.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15714.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15714.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30627.6},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15714.59,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15534.92,"10th_percentile":15534.92,"90th_percentile":15534.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Infectious And Parasitic Diseases Diagnoses With Cc","code_information":[{"code":"868","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6192.74,"maximum":15168.02,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15168.02},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7740.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9479.12},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11615.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7740.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13816.64},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7740.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7895.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7740.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7740.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6192.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7740.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7740.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7740.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14336.32},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7740.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Infectious And Parasitic Diseases Diagnoses Without Cc/Mcc","code_information":[{"code":"869","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4382.55,"maximum":10058.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10058.64},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6286.05},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7702.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9162.47},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5587.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4382.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5478.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9507.1},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5478.19,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":9031.37,"10th_percentile":9031.37,"90th_percentile":9031.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Septicemia Or Severe Sepsis With Mv >96 Hours","code_information":[{"code":"870","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":41511.98,"maximum":102946.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":102946.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51889.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":64335.69},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":78833.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51889.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":93774.86},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51889.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":52927.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51889.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51889.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":41511.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":51889.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51889.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51889.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":97302.0},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51889.98,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":51249.35,"10th_percentile":51249.35,"90th_percentile":51249.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":51244.53,"10th_percentile":12126.41,"90th_percentile":70717.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc","code_information":[{"code":"871","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11666.58,"maximum":28645.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28645.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14583.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17901.91},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21935.93},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14583.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26093.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14583.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14874.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14583.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14583.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11666.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14583.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14583.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14583.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27075.05},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14583.22,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":27430.04,"10th_percentile":14450.02,"90th_percentile":28828.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"25","median_amount":7867.01,"10th_percentile":5951.37,"90th_percentile":14426.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"28","median_amount":24122.08,"10th_percentile":18730.2,"90th_percentile":36618.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":13133.39,"10th_percentile":12253.39,"90th_percentile":14177.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"14","median_amount":24606.81,"10th_percentile":12215.03,"90th_percentile":27958.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"73","median_amount":14401.81,"10th_percentile":5977.55,"90th_percentile":14437.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":745.56,"10th_percentile":745.56,"90th_percentile":745.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15270.41,"10th_percentile":15270.41,"90th_percentile":15270.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":10177.26,"10th_percentile":10177.26,"90th_percentile":10177.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":28991.81,"10th_percentile":8328.62,"90th_percentile":28991.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"31","median_amount":14120.76,"10th_percentile":2200.0,"90th_percentile":14157.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc","code_information":[{"code":"872","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6145.9,"maximum":14924.86,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14924.86},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7682.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9327.16},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11428.94},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7682.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13595.14},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7682.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7836.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7682.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7682.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6145.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7682.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7682.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7682.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14106.49},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7682.37,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":14450.02,"10th_percentile":14450.02,"90th_percentile":14450.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"11","median_amount":7586.82,"10th_percentile":1185.0,"90th_percentile":7619.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":11035.38,"10th_percentile":9524.31,"90th_percentile":19139.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7468.41,"10th_percentile":7468.41,"90th_percentile":14177.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":9667.92,"10th_percentile":6330.57,"90th_percentile":12726.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"16","median_amount":7586.82,"10th_percentile":6464.49,"90th_percentile":7645.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4519.22,"10th_percentile":4519.22,"90th_percentile":4524.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":14340.53,"10th_percentile":11344.33,"90th_percentile":15272.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"12","median_amount":7440.56,"10th_percentile":2200.0,"90th_percentile":7469.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. Procedures With Principal Diagnosis Of Mental Illness","code_information":[{"code":"876","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23212.43,"maximum":54567.81,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54567.81},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29015.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34101.66},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41786.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29015.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49706.13},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29015.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29595.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29015.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29015.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23212.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29015.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29015.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29015.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51575.72},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29015.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Acute Adjustment Reaction And Psychosocial Dysfunction","code_information":[{"code":"880","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5766.92,"maximum":13798.01,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13798.01},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7208.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8622.94},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10566.03},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7208.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12568.68},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7208.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7352.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7208.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7208.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5766.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7208.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7208.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7208.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13041.43},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7208.65,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Depressive Neuroses","code_information":[{"code":"881","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5651.01,"maximum":13289.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13289.44},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7063.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8305.12},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10176.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7063.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12105.43},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7063.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7205.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7063.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7063.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5651.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7063.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7063.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7063.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12560.75},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7063.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Neuroses Except Depressive","code_information":[{"code":"882","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6449.2,"maximum":14757.31,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14757.31},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8061.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9222.45},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11300.64},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8061.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13442.52},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8061.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8222.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8061.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8061.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6449.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8061.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8061.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8061.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13948.13},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8061.5,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Disorders Of Personality And Impulse Control","code_information":[{"code":"883","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11809.52,"maximum":26239.34,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26239.34},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14761.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16398.04},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20093.17},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14761.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23901.57},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14761.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15057.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14761.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14761.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11809.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14761.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14761.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14761.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24800.58},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14761.9,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Organic Disturbances And Intellectual Disability","code_information":[{"code":"884","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9662.98,"maximum":23720.23,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23720.23},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12078.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14823.75},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18164.13},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12078.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21606.9},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12078.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12320.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12078.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12078.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9662.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12078.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12078.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12078.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22419.6},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12078.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11936.47,"10th_percentile":10375.2,"90th_percentile":11953.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":280.99,"10th_percentile":280.99,"90th_percentile":280.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Psychoses","code_information":[{"code":"885","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8389.12,"maximum":20615.46,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20615.46},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10486.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12883.45},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15786.6},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10486.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18778.74},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10486.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10696.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10486.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10486.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8389.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10486.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10486.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10486.4,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19485.07},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10486.4,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":14712.49,"10th_percentile":14712.49,"90th_percentile":14712.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Behavioral And Developmental Disorders","code_information":[{"code":"886","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12464.17,"maximum":27693.87,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27693.87},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15580.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17307.03},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21207.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15580.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25226.51},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15580.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15891.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15580.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15580.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12464.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15580.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15580.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15580.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26175.35},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15580.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Mental Disorder Diagnoses","code_information":[{"code":"887","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6431.78,"maximum":16538.04,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16538.04},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8039.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10335.3},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12664.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8039.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15064.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8039.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8200.52,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8039.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8039.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6431.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8039.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8039.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8039.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15631.22},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8039.73,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":280.59,"10th_percentile":280.59,"90th_percentile":280.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Alcohol, Drug Abuse Or Dependence, Left Ama","code_information":[{"code":"894","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3705.07,"maximum":9299.49,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9299.49},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4631.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5811.64},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7121.23},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4631.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8470.96},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4631.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4723.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4631.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4631.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3705.07,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4631.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4631.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4631.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8789.58},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4631.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11270.02,"10th_percentile":11270.02,"90th_percentile":11270.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":6497.81,"10th_percentile":6497.81,"90th_percentile":6497.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc","code_information":[{"code":"896","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10481.0,"maximum":24627.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24627.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13101.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15390.83},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18858.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13101.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22433.47},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13101.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13363.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13101.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13101.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10481.0,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13101.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13101.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13101.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23277.25},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13101.25,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6589.74,"10th_percentile":6589.74,"90th_percentile":6589.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18105.41,"10th_percentile":14675.8,"90th_percentile":65197.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18404.73,"10th_percentile":18404.73,"90th_percentile":18404.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":18381.14,"10th_percentile":18381.14,"90th_percentile":18757.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12941.9,"10th_percentile":10805.48,"90th_percentile":12994.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4194.38,"10th_percentile":4194.38,"90th_percentile":4194.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":24455.83,"10th_percentile":24455.83,"90th_percentile":24455.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12716.2,"10th_percentile":12716.2,"90th_percentile":12716.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc","code_information":[{"code":"897","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5302.06,"maximum":12728.98,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12728.98},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6627.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7954.86},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9747.41},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6627.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11594.9},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6627.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6760.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6627.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6627.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5302.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6627.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6627.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6627.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12031.02},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6627.58,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"1 through 10","median_amount":13089.28,"10th_percentile":13089.28,"90th_percentile":13089.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11637.09,"10th_percentile":9159.05,"90th_percentile":16641.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5768.6,"10th_percentile":5768.6,"90th_percentile":5768.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":9288.82,"10th_percentile":9288.82,"90th_percentile":9288.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":12371.56,"10th_percentile":12371.56,"90th_percentile":12371.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6442.91,"10th_percentile":6442.91,"90th_percentile":6442.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Wound Debridements For Injuries With Mcc","code_information":[{"code":"901","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25204.61,"maximum":66336.0,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66336.0},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31505.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":41456.08},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50797.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31505.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60425.84},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31505.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32135.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31505.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31505.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25204.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31505.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31505.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31505.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":62698.64},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31505.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":16919.64,"10th_percentile":16919.64,"90th_percentile":16919.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":6675.72,"10th_percentile":6675.72,"90th_percentile":6675.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Wound Debridements For Injuries With Cc","code_information":[{"code":"902","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11498.41,"maximum":28079.37,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28079.37},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14373.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17547.95},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21502.21},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14373.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":25577.66},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14373.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14660.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14373.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14373.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11498.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14373.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14373.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14373.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26539.71},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14373.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14194.22,"10th_percentile":14194.22,"90th_percentile":14194.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Wound Debridements For Injuries Without Cc/Mcc","code_information":[{"code":"903","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7024.57,"maximum":16662.58,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16662.58},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8780.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10413.13},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12759.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8780.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15178.04},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8780.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8956.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8780.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8780.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7024.57,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8780.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8780.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8780.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15748.93},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8780.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":550.0,"10th_percentile":550.0,"90th_percentile":550.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Grafts For Injuries With Cc/Mcc","code_information":[{"code":"904","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22060.49,"maximum":55000.76,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55000.76},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27575.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":34372.23},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42117.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27575.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":50100.51},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27575.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28127.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27575.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27575.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22060.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27575.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27575.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27575.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51984.93},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27575.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Skin Grafts For Injuries Without Cc/Mcc","code_information":[{"code":"905","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":8909.24,"maximum":23042.64,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23042.64},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11136.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14400.29},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17645.25},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11136.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20989.67},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11136.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11359.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11136.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11136.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8909.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11136.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11136.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11136.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21779.16},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11136.55,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hand Procedures For Injuries","code_information":[{"code":"906","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11797.5,"maximum":26212.65,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26212.65},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14746.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16381.36},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20072.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14746.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23877.26},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14746.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15041.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14746.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14746.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11797.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14746.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14746.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14746.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24775.35},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14746.88,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures For Injuries With Mcc","code_information":[{"code":"907","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23058.68,"maximum":57768.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57768.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28823.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":36102.19},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44237.45},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28823.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":52622.08},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28823.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29399.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28823.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28823.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23058.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28823.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28823.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28823.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":54601.35},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28823.35,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":54710.03,"10th_percentile":54710.03,"90th_percentile":54710.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28487.49,"10th_percentile":28487.49,"90th_percentile":28487.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":27921.68,"10th_percentile":27921.68,"90th_percentile":27921.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures For Injuries With Cc","code_information":[{"code":"908","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":11983.09,"maximum":29029.78,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29029.78},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14978.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18141.9},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22230.0},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14978.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26443.4},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14978.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15278.44,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14978.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14978.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11983.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14978.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14978.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14978.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27438.01},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14978.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7706.24,"10th_percentile":7706.24,"90th_percentile":7706.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":25787.96,"10th_percentile":25787.96,"90th_percentile":25787.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14799.92,"10th_percentile":14799.92,"90th_percentile":14799.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":27960.73,"10th_percentile":27960.73,"90th_percentile":27960.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14544.76,"10th_percentile":14544.76,"90th_percentile":14544.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures For Injuries Without Cc/Mcc","code_information":[{"code":"909","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7884.02,"maximum":20476.09,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20476.09},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9855.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12796.35},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15679.87},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9855.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18651.79},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9855.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10052.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9855.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9855.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7884.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9855.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9855.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9855.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19353.33},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9855.03,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24745.71,"10th_percentile":24745.71,"90th_percentile":24745.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Injury With Mcc","code_information":[{"code":"913","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9817.34,"maximum":22904.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22904.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12271.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14314.12},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17539.66},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12271.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20864.07},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12271.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12517.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12271.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12271.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9817.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12271.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12271.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12271.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21648.83},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12271.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12135.03,"10th_percentile":12135.03,"90th_percentile":12135.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Traumatic Injury Without Mcc","code_information":[{"code":"914","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5318.28,"maximum":13760.94,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13760.94},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6647.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8599.77},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10537.65},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6647.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12534.92},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6647.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6780.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6647.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6647.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5318.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6647.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6647.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6647.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13006.39},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6647.85,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":448.29,"10th_percentile":448.29,"90th_percentile":448.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Allergic Reactions With Mcc","code_information":[{"code":"915","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10099.62,"maximum":24552.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24552.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12624.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15343.57},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18801.09},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12624.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22364.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12624.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12877.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12624.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12624.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10099.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12624.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12624.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12624.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23205.78},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12624.53,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":19982.52,"10th_percentile":19982.52,"90th_percentile":19982.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Allergic Reactions Without Mcc","code_information":[{"code":"916","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4001.77,"maximum":10269.18,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10269.18},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5002.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6417.63},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7863.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5002.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9354.26},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5002.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5102.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5002.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5002.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4001.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5002.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5002.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5002.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9706.1},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5002.21,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":4956.25,"10th_percentile":4956.25,"90th_percentile":4956.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":485.06,"10th_percentile":485.06,"90th_percentile":485.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Poisoning And Toxic Effects Of Drugs With Mcc","code_information":[{"code":"917","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9419.74,"maximum":23275.42,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23275.42},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11774.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14545.77},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17823.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11774.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21201.72},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11774.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12010.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11774.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11774.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9419.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11774.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11774.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11774.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21999.18},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11774.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11663.02,"10th_percentile":11663.02,"90th_percentile":11663.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9205.61,"10th_percentile":9205.61,"90th_percentile":11605.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11628.21,"10th_percentile":11628.21,"90th_percentile":11642.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":21979.56,"10th_percentile":21979.56,"90th_percentile":21979.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11400.22,"10th_percentile":11400.22,"90th_percentile":11400.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Poisoning And Toxic Effects Of Drugs Without Mcc","code_information":[{"code":"918","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5147.7,"maximum":12923.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12923.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6434.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8076.25},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9896.15},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6434.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11771.83},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6434.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6563.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6434.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6434.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5147.7,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6434.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6434.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6434.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12214.6},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6434.63,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6374.59,"10th_percentile":6374.59,"90th_percentile":6374.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":12011.4,"10th_percentile":12011.4,"90th_percentile":12011.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":6240.29,"10th_percentile":6240.29,"90th_percentile":6240.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complications Of Treatment With Mcc","code_information":[{"code":"919","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10995.71,"maximum":26131.1,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26131.1},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13744.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16330.4},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20010.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13744.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23802.97},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13744.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14019.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13744.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13744.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10995.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13744.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13744.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13744.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24698.27},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13744.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26088.9,"10th_percentile":26088.9,"90th_percentile":26088.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":11441.83,"10th_percentile":11441.83,"90th_percentile":11441.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":13031.92,"10th_percentile":13031.92,"90th_percentile":13031.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13573.67,"10th_percentile":13573.67,"90th_percentile":13584.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":3279.81,"10th_percentile":3279.81,"90th_percentile":3279.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2288.37,"10th_percentile":2288.37,"90th_percentile":2288.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13325.36,"10th_percentile":13325.36,"90th_percentile":13325.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complications Of Treatment With Cc","code_information":[{"code":"920","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6019.78,"maximum":14789.93,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14789.93},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7524.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9242.84},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11325.62},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7524.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13472.24},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7524.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7675.21,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7524.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7524.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6019.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7524.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7524.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7524.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13978.97},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7524.72,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7436.9,"10th_percentile":7436.9,"90th_percentile":7436.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13189.56,"10th_percentile":13189.56,"90th_percentile":13706.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":2011.0,"10th_percentile":2011.0,"90th_percentile":2011.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3118.83,"10th_percentile":3118.83,"90th_percentile":3118.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7439.81,"10th_percentile":7439.81,"90th_percentile":7466.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":124.5,"10th_percentile":124.5,"90th_percentile":124.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7326.99,"10th_percentile":7326.99,"90th_percentile":7330.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complications Of Treatment Without Cc/Mcc","code_information":[{"code":"921","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4134.5,"maximum":9962.26,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9962.26},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5168.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6225.83},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7628.75},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5168.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9074.68},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5168.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5271.49,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5168.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5168.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4134.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5168.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5168.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5168.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9416.01},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":5168.13,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":7884.91,"10th_percentile":7884.91,"90th_percentile":7884.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":10274.37,"10th_percentile":10274.37,"90th_percentile":10274.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc","code_information":[{"code":"922","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10506.82,"maximum":24090.91,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24090.91},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13133.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15055.4},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18447.98},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13133.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21944.55},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13133.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13396.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13133.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13133.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10506.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13133.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13133.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13133.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22769.95},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13133.53,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12591.26,"10th_percentile":12591.26,"90th_percentile":12591.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc","code_information":[{"code":"923","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6112.26,"maximum":14797.35,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14797.35},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7640.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9247.47},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11331.29},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7640.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13478.99},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7640.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7793.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7640.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7640.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6112.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7640.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7640.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7640.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13985.97},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7640.33,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12314.58,"10th_percentile":12314.58,"90th_percentile":12314.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":7546.89,"10th_percentile":7546.89,"90th_percentile":7546.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft","code_information":[{"code":"927","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":128230.22,"maximum":412688.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":412688.79},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":160287.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":257906.14},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":316022.69},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":160287.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":375920.6},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":160287.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":163493.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":160287.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":160287.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":128230.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":160287.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":160287.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":160287.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":390060.07},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":160287.78,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc","code_information":[{"code":"928","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":43078.94,"maximum":113343.52,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":113343.52},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53848.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":70833.01},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":86794.52},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53848.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":103245.27},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53848.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":54925.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53848.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53848.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":43078.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":53848.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53848.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53848.67,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":107128.62},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":53848.67,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc","code_information":[{"code":"929","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":19343.99,"maximum":44747.89,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44747.89},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24179.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":27964.79},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34266.37},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24179.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40761.11},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24179.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24663.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24179.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24179.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19343.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24179.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24179.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24179.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42294.25},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24179.99,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft","code_information":[{"code":"933","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":23388.41,"maximum":51965.67,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51965.67},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29235.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":32475.48},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39793.5},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29235.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":47335.83},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29235.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29820.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29235.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29235.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":23388.41,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29235.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29235.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29235.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49116.27},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":29235.51,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Full Thickness Burn Without Skin Graft Or Inhalation Injury","code_information":[{"code":"934","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":13276.78,"maximum":29498.32,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29498.32},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16595.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18434.71},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22588.78},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16595.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26870.19},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16595.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16927.89,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16595.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16595.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":13276.78,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":16595.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16595.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16595.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27880.85},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16595.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Extensive Burns","code_information":[{"code":"935","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12372.27,"maximum":35928.79,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35928.79},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15465.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22453.37},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27513.01},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15465.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32727.74},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15465.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15774.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15465.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15465.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12372.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15465.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15465.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15465.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33958.72},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15465.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. 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Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. Procedures With Diagnoses Of Other Contact With Health Services With Cc","code_information":[{"code":"940","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14035.33,"maximum":31304.25,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":31304.25},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17544.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19563.31},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23971.7},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17544.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28515.22},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17544.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17895.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17544.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17544.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14035.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":17544.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17544.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17544.16,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29587.76},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17544.16,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"O.R. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/Mcc","code_information":[{"code":"941","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":12178.28,"maximum":28822.21,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":28822.21},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15222.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18012.18},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22071.04},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15222.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":26254.31},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15222.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15527.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15222.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15222.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12178.28,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15222.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15222.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15222.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27241.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15222.85,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Rehabilitation With Cc/Mcc","code_information":[{"code":"945","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9300.82,"maximum":21859.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21859.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11626.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13660.86},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16739.2},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11626.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19911.9},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11626.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11858.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11626.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11626.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9300.82,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11626.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11626.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11626.03,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20660.84},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11626.03,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Rehabilitation Without Cc/Mcc","code_information":[{"code":"946","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":6887.63,"maximum":16377.9,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16377.9},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8609.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10235.22},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12541.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8609.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14918.73},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8609.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8781.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8609.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8609.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":6887.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8609.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8609.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8609.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15479.86},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8609.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Signs And Symptoms With Mcc","code_information":[{"code":"947","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7623.96,"maximum":18693.88,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18693.88},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9529.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11682.57},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14315.12},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9529.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17028.36},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9529.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9720.55,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9529.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9529.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7623.96,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9529.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9529.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9529.95,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17668.85},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9529.95,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14535.79,"10th_percentile":14535.79,"90th_percentile":14535.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":8685.52,"10th_percentile":8685.52,"90th_percentile":8685.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":13370.59,"10th_percentile":13370.59,"90th_percentile":13370.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":9442.29,"10th_percentile":9442.29,"90th_percentile":9442.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1239.46,"10th_percentile":1239.46,"90th_percentile":1239.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Signs And Symptoms Without Mcc","code_information":[{"code":"948","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":4807.77,"maximum":11613.99,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11613.99},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6009.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7258.06},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8893.59},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6009.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10579.25},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6009.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6129.9,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6009.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6009.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":4807.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6009.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6009.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6009.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10977.17},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6009.71,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5982.92,"10th_percentile":5982.92,"90th_percentile":5982.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15090.23,"10th_percentile":15090.23,"90th_percentile":15090.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":8368.47,"10th_percentile":8368.47,"90th_percentile":20224.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":2552.88,"10th_percentile":351.59,"90th_percentile":5935.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":252.91,"10th_percentile":252.91,"90th_percentile":252.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":5829.59,"10th_percentile":130.0,"90th_percentile":5830.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aftercare With Cc/Mcc","code_information":[{"code":"949","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7145.29,"maximum":16652.2,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16652.2},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8931.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10406.64},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12751.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8931.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15168.59},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8931.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9110.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8931.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8931.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7145.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":8931.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8931.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8931.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15739.12},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":8931.61,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Aftercare Without Cc/Mcc","code_information":[{"code":"950","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3769.94,"maximum":11358.96,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11358.96},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4712.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7098.68},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8698.3},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4712.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10346.95},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4712.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4806.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4712.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4712.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3769.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4712.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4712.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4712.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10736.13},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4712.43,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Factors Influencing Health Status","code_information":[{"code":"951","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":3339.31,"maximum":8264.57,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":8264.57},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4174.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":5164.87},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":6328.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4174.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7528.24},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4174.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4257.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4174.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4174.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":3339.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":4174.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4174.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4174.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":7811.4},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":4174.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":1381.0,"10th_percentile":1381.0,"90th_percentile":1381.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Craniotomy For Multiple Significant Trauma","code_information":[{"code":"955","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":40426.71,"maximum":96756.55,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":96756.55},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50533.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":60467.14},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":74092.8},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50533.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":88136.1},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50533.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":51544.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50533.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50533.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":40426.71,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":50533.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50533.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50533.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":91451.16},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":50533.39,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma","code_information":[{"code":"956","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":22600.42,"maximum":56800.75,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":56800.75},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28250.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35497.12},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":43496.04},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28250.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":51740.14},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28250.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28815.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28250.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28250.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":22600.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28250.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28250.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28250.53,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53686.23},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":28250.53,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures For Multiple Significant Trauma With Mcc","code_information":[{"code":"957","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":45764.81,"maximum":111946.82,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":111946.82},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57206.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":69960.15},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":85724.97},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57206.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":101973.0},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57206.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":58350.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57206.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57206.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":45764.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":57206.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57206.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57206.01,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":105808.5},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":57206.01,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures For Multiple Significant Trauma With Cc","code_information":[{"code":"958","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":25308.51,"maximum":60420.03,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":60420.03},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31635.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":37758.95},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46267.55},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31635.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":55036.95},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31635.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":32268.35,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31635.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31635.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":25308.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31635.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31635.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31635.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":57107.05},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":31635.64,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other O.R. Procedures For Multiple Significant Trauma Without Cc/Mcc","code_information":[{"code":"959","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17682.14,"maximum":40200.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":40200.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22102.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25122.91},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":30784.1},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22102.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36618.82},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22102.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22544.73,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22102.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22102.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17682.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22102.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22102.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22102.68,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":37996.16},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22102.68,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Multiple Significant Trauma With Mcc","code_information":[{"code":"963","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":16419.09,"maximum":39085.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":39085.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20523.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24426.1},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":29930.28},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20523.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35603.17},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20523.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20934.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20523.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20523.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16419.09,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20523.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20523.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20523.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":36942.31},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20523.86,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20272.48,"10th_percentile":20272.48,"90th_percentile":20272.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Multiple Significant Trauma With Cc","code_information":[{"code":"964","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9204.74,"maximum":22197.5,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22197.5},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11505.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13872.13},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16998.07},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11505.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20219.83},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11505.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11736.04,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11505.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11505.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9204.74,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11505.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11505.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11505.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20980.36},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11505.92,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Other Multiple Significant Trauma Without Cc/Mcc","code_information":[{"code":"965","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5648.61,"maximum":14907.07,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14907.07},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7060.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9316.04},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11415.31},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7060.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":13578.93},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7060.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7201.98,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7060.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7060.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5648.61,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7060.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7060.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7060.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14089.68},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":7060.76,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hiv With Extensive O.R. Procedures With Mcc","code_information":[{"code":"969","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":36764.27,"maximum":106374.83,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":106374.83},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45955.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":66477.99},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":81458.14},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45955.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":96897.45},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45955.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":46874.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45955.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45955.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":36764.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":45955.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45955.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45955.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":100542.04},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":45955.34,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hiv With Extensive O.R. Procedures Without Mcc","code_information":[{"code":"970","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":15840.11,"maximum":46638.33,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46638.33},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19800.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":29146.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35714.01},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19800.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42483.12},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19800.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20196.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19800.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19800.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":15840.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":19800.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19800.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19800.14,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":44081.04},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":19800.14,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hiv With Major Related Condition With Mcc","code_information":[{"code":"974","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":17333.2,"maximum":45204.56,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45204.56},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21666.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":28250.18},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":34616.08},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21666.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":41177.09},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21666.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":22099.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21666.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21666.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":17333.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":21666.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21666.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21666.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":42725.88},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21666.5,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hiv With Major Related Condition With Cc","code_information":[{"code":"975","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7777.72,"maximum":19639.84,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19639.84},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9722.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12273.74},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15039.51},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9722.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":17890.05},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9722.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9916.59,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9722.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9722.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7777.72,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9722.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9722.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9722.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18562.94},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9722.15,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hiv With Major Related Condition Without Cc/Mcc","code_information":[{"code":"976","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":5421.58,"maximum":12045.45,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12045.45},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":7527.7},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":9223.99},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":10972.27},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6912.51,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":5421.58,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":6776.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":11384.97},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":6776.97,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hiv With Or Without Other Related Condition","code_information":[{"code":"977","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7793.94,"maximum":20637.7,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":20637.7},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12897.35},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15803.63},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18799.0},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9937.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7793.94,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9742.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":19506.09},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9742.42,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive O.R. Procedures Unrelated To Principal Diagnosis With Mcc","code_information":[{"code":"981","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":28178.76,"maximum":70333.36,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":70333.36},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35223.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":43954.2},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":53858.83},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35223.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":64067.06},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35223.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35927.92,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35223.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35223.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":28178.76,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":35223.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35223.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35223.45,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":66476.81},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":35223.45,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":34801.18,"10th_percentile":34801.18,"90th_percentile":34801.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":169573.09,"10th_percentile":169573.09,"90th_percentile":169573.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":33792.43,"10th_percentile":33792.43,"90th_percentile":33792.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":39057.82,"10th_percentile":39057.82,"90th_percentile":39057.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":65750.89,"10th_percentile":65750.89,"90th_percentile":65750.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":34136.74,"10th_percentile":34136.74,"90th_percentile":34136.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive O.R. Procedures Unrelated To Principal Diagnosis With Cc","code_information":[{"code":"982","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":14765.65,"maximum":35958.44,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":35958.44},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18457.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":22471.9},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":27535.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18457.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":32754.75},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18457.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18826.2,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18457.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18457.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14765.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":18457.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18457.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18457.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":33986.75},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18457.06,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18227.48,"10th_percentile":18227.48,"90th_percentile":18227.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":72162.07,"10th_percentile":72162.07,"90th_percentile":72162.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":18229.88,"10th_percentile":18227.48,"90th_percentile":18235.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":274.09,"10th_percentile":274.09,"90th_percentile":274.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Extensive O.R. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc","code_information":[{"code":"983","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":10294.22,"maximum":23929.3,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23929.3},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12867.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14954.4},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18324.22},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12867.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":21797.33},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12867.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13125.13,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12867.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12867.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10294.22,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12867.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12867.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12867.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22617.19},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12867.77,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":16199.07,"10th_percentile":16199.07,"90th_percentile":16199.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis With Mcc","code_information":[{"code":"987","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":20590.83,"maximum":49701.59,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":49701.59},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25738.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":31060.56},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":38059.74},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25738.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":45273.46},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25738.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26253.31,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25738.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25738.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20590.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25738.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25738.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25738.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":46976.33},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25738.54,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25418.37,"10th_percentile":25418.37,"90th_percentile":25418.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":22497.21,"10th_percentile":22497.21,"90th_percentile":22497.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24952.1,"10th_percentile":24952.1,"90th_percentile":24952.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis With Cc","code_information":[{"code":"988","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":9871.39,"maximum":24427.48,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":24427.48},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12339.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15265.74},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":18705.72},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12339.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":22251.14},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12339.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12586.02,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12339.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12339.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9871.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12339.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12339.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12339.24,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":23088.07},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12339.24,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":20629.12,"10th_percentile":20629.12,"90th_percentile":33384.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":12201.89,"10th_percentile":12201.89,"90th_percentile":12201.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc","code_information":[{"code":"989","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","minimum":7202.34,"maximum":16367.53,"payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":16367.53},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9002.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10228.74},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":12533.68},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9002.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":14909.27},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9002.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9182.99,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9002.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9002.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":7202.34,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":9002.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9002.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9002.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"fee schedule","standard_charge_dollar":15470.05},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":9002.93,"additional_payer_notes":"MSDRG Base Rate"}]},{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inj, bupivacaine liposome","code_information":[{"code":"0763","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":452.77,"10th_percentile":452.77,"90th_percentile":452.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ketorolac tromethamine inj","code_information":[{"code":"0764","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":5587.41,"10th_percentile":5587.41,"90th_percentile":5587.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":2135.0,"10th_percentile":2135.0,"90th_percentile":2135.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Inj, methylpred acetate 1 mg","code_information":[{"code":"0790","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":2142.18,"10th_percentile":2142.18,"90th_percentile":2142.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":82.0,"10th_percentile":82.0,"90th_percentile":82.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gammagard liquid/erc inj","code_information":[{"code":"0944","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":3056.5,"10th_percentile":3056.5,"90th_percentile":3056.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"New Technology - Level 11 ($901 - $1000)","code_information":[{"code":"1511","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"12","median_amount":518.13,"10th_percentile":349.7,"90th_percentile":1335.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":1338.97,"10th_percentile":358.34,"90th_percentile":3807.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"61","median_amount":1235.0,"10th_percentile":1027.89,"90th_percentile":4823.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1312.73,"10th_percentile":956.0,"90th_percentile":1312.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"39","median_amount":996.0,"10th_percentile":612.17,"90th_percentile":1777.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"24","median_amount":1333.93,"10th_percentile":363.34,"90th_percentile":1344.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"38","median_amount":2532.52,"10th_percentile":669.0,"90th_percentile":2850.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":1306.23,"10th_percentile":1288.53,"90th_percentile":2556.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Gen, neuro, clo loop, rechg","code_information":[{"code":"2038","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3464.71,"10th_percentile":3464.71,"90th_percentile":3464.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Endo, single, pulmonary","code_information":[{"code":"2042","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":7473.12,"10th_percentile":7473.12,"90th_percentile":7473.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Tissue marker, detectable","code_information":[{"code":"2055","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":6204.0,"10th_percentile":6204.0,"90th_percentile":6204.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":3235.4,"10th_percentile":3235.4,"90th_percentile":3235.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Brachytx, non-str,Yttrium-90","code_information":[{"code":"2616","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":11510.61,"10th_percentile":11510.61,"90th_percentile":29668.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":29086.62,"10th_percentile":29086.62,"90th_percentile":29086.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Clinic Visits and Related Services","code_information":[{"code":"5012","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":138.86,"10th_percentile":138.3,"90th_percentile":546.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"94","median_amount":138.3,"10th_percentile":129.31,"90th_percentile":139.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"69","median_amount":648.0,"10th_percentile":136.14,"90th_percentile":780.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"29","median_amount":127.29,"10th_percentile":127.29,"90th_percentile":136.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":485.37,"10th_percentile":485.37,"90th_percentile":574.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":113.64,"10th_percentile":113.64,"90th_percentile":113.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"74","median_amount":129.31,"10th_percentile":129.31,"90th_percentile":138.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"38","median_amount":68.0,"10th_percentile":64.0,"90th_percentile":120.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"66","median_amount":135.59,"10th_percentile":126.78,"90th_percentile":135.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Type A ED Visits","code_information":[{"code":"5021","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":549.0,"10th_percentile":549.0,"90th_percentile":549.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"21","median_amount":282.0,"10th_percentile":192.0,"90th_percentile":839.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":86.65,"10th_percentile":86.65,"90th_percentile":86.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"17","median_amount":549.0,"10th_percentile":549.0,"90th_percentile":1360.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":157.25,"10th_percentile":90.53,"90th_percentile":175.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":89.38,"10th_percentile":89.38,"90th_percentile":184.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":110.67,"10th_percentile":110.67,"90th_percentile":110.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"11","median_amount":161.29,"10th_percentile":157.25,"90th_percentile":175.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"11","median_amount":549.0,"10th_percentile":549.0,"90th_percentile":1048.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":87.63,"10th_percentile":87.63,"90th_percentile":87.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Type A ED Visits","code_information":[{"code":"5022","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"23","median_amount":866.0,"10th_percentile":758.0,"90th_percentile":909.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"25","median_amount":161.4,"10th_percentile":159.49,"90th_percentile":162.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"140","median_amount":1293.0,"10th_percentile":1046.0,"90th_percentile":1910.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":157.01,"10th_percentile":156.42,"90th_percentile":247.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"136","median_amount":1360.0,"10th_percentile":1131.0,"90th_percentile":1360.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"91","median_amount":161.29,"10th_percentile":100.31,"90th_percentile":235.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"88","median_amount":162.09,"10th_percentile":159.49,"90th_percentile":162.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":182.48,"10th_percentile":182.48,"90th_percentile":182.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2070.0,"10th_percentile":2070.0,"90th_percentile":2070.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"49","median_amount":131.12,"10th_percentile":106.67,"90th_percentile":210.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"183","median_amount":149.54,"10th_percentile":100.31,"90th_percentile":207.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"86","median_amount":1125.0,"10th_percentile":1099.0,"90th_percentile":1170.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"43","median_amount":158.97,"10th_percentile":156.37,"90th_percentile":245.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Type A ED Visits","code_information":[{"code":"5023","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"85","median_amount":1332.0,"10th_percentile":1166.0,"90th_percentile":1399.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"97","median_amount":285.84,"10th_percentile":280.33,"90th_percentile":375.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":1572.34,"10th_percentile":596.0,"90th_percentile":4685.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"484","median_amount":1293.0,"10th_percentile":1046.0,"90th_percentile":1865.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"50","median_amount":279.12,"10th_percentile":273.49,"90th_percentile":369.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"413","median_amount":1756.24,"10th_percentile":1557.0,"90th_percentile":1948.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"301","median_amount":182.21,"10th_percentile":100.31,"90th_percentile":267.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"211","median_amount":280.63,"10th_percentile":89.38,"90th_percentile":368.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":130.75,"10th_percentile":109.75,"90th_percentile":765.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":872.05,"10th_percentile":872.05,"90th_percentile":1695.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"237","median_amount":127.24,"10th_percentile":100.31,"90th_percentile":248.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"763","median_amount":189.53,"10th_percentile":104.01,"90th_percentile":286.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"249","median_amount":1357.0,"10th_percentile":1274.0,"90th_percentile":1357.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3593.0,"10th_percentile":3593.0,"90th_percentile":3593.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"126","median_amount":280.59,"10th_percentile":274.89,"90th_percentile":280.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Level 4 Type A ED Visits","code_information":[{"code":"5024","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"353","median_amount":1354.04,"10th_percentile":1169.62,"90th_percentile":2539.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"447","median_amount":669.15,"10th_percentile":438.16,"90th_percentile":945.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":596.0,"10th_percentile":596.0,"90th_percentile":5106.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1830","median_amount":1907.29,"10th_percentile":1425.0,"90th_percentile":2818.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"235","median_amount":656.15,"10th_percentile":515.65,"90th_percentile":958.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"965","median_amount":1948.0,"10th_percentile":1570.0,"90th_percentile":1948.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":246.76,"10th_percentile":246.76,"90th_percentile":246.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"208","median_amount":295.35,"10th_percentile":135.79,"90th_percentile":512.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"979","median_amount":641.17,"10th_percentile":373.94,"90th_percentile":953.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":182.48,"10th_percentile":182.48,"90th_percentile":576.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1182.58,"10th_percentile":1182.58,"90th_percentile":1876.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"146","median_amount":282.34,"10th_percentile":118.02,"90th_percentile":624.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"512","median_amount":298.43,"10th_percentile":127.62,"90th_percentile":546.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"789","median_amount":1582.0,"10th_percentile":1307.0,"90th_percentile":1685.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"494","median_amount":669.83,"10th_percentile":428.19,"90th_percentile":956.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Type A ED Visits","code_information":[{"code":"5025","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"212","median_amount":2456.08,"10th_percentile":2133.61,"90th_percentile":4129.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"298","median_amount":1309.48,"10th_percentile":290.0,"90th_percentile":2847.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":1646.12,"10th_percentile":1646.12,"90th_percentile":1679.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1217","median_amount":1910.57,"10th_percentile":1191.63,"90th_percentile":3796.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"164","median_amount":1344.53,"10th_percentile":779.74,"90th_percentile":2848.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"600","median_amount":1948.0,"10th_percentile":1570.0,"90th_percentile":2135.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":225.0,"10th_percentile":225.0,"90th_percentile":225.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"95","median_amount":484.26,"10th_percentile":294.96,"90th_percentile":873.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"775","median_amount":1123.96,"10th_percentile":618.62,"90th_percentile":2828.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"66","median_amount":863.79,"10th_percentile":429.76,"90th_percentile":1279.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1043.01,"10th_percentile":1043.01,"90th_percentile":1043.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5119.77,"10th_percentile":5119.77,"90th_percentile":5119.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"47","median_amount":530.13,"10th_percentile":237.83,"90th_percentile":930.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"193","median_amount":416.73,"10th_percentile":231.7,"90th_percentile":737.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"453","median_amount":1685.0,"10th_percentile":1525.0,"90th_percentile":5139.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"405","median_amount":1311.29,"10th_percentile":782.51,"90th_percentile":2826.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Critical Care","code_information":[{"code":"5041","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"11","median_amount":4678.37,"10th_percentile":1533.0,"90th_percentile":9394.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"26","median_amount":1738.17,"10th_percentile":1151.92,"90th_percentile":2816.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"39","median_amount":2824.54,"10th_percentile":1380.8,"90th_percentile":6204.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":2187.22,"10th_percentile":1169.05,"90th_percentile":2822.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"23","median_amount":1993.0,"10th_percentile":1634.0,"90th_percentile":2135.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":684.58,"10th_percentile":513.8,"90th_percentile":756.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"64","median_amount":1475.61,"10th_percentile":1059.28,"90th_percentile":2574.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1394.44,"10th_percentile":1329.81,"90th_percentile":1574.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":499.17,"10th_percentile":172.0,"90th_percentile":707.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":396.96,"10th_percentile":231.67,"90th_percentile":760.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"21","median_amount":1736.0,"10th_percentile":1736.0,"90th_percentile":5124.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"17","median_amount":1940.11,"10th_percentile":1330.87,"90th_percentile":2717.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Skin Procedures","code_information":[{"code":"5051","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":240.8,"10th_percentile":240.8,"90th_percentile":346.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":212.67,"10th_percentile":199.37,"90th_percentile":328.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":2849.0,"10th_percentile":2849.0,"90th_percentile":2849.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":206.17,"10th_percentile":206.17,"90th_percentile":206.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":109.0,"10th_percentile":109.0,"90th_percentile":558.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":199.37,"10th_percentile":199.37,"90th_percentile":211.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":344.0,"10th_percentile":120.4,"90th_percentile":562.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":208.5,"10th_percentile":199.45,"90th_percentile":208.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Skin Procedures","code_information":[{"code":"5052","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"18","median_amount":1780.1,"10th_percentile":422.26,"90th_percentile":2326.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"175","median_amount":422.26,"10th_percentile":400.88,"90th_percentile":560.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"110","median_amount":2380.0,"10th_percentile":417.73,"90th_percentile":3073.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"78","median_amount":415.67,"10th_percentile":394.62,"90th_percentile":554.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"54","median_amount":2543.0,"10th_percentile":1570.0,"90th_percentile":2604.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":389.34,"10th_percentile":389.34,"90th_percentile":389.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"52","median_amount":423.06,"10th_percentile":401.68,"90th_percentile":564.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2346.0,"10th_percentile":2346.0,"90th_percentile":2346.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":370.5,"10th_percentile":370.5,"90th_percentile":389.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":279.59,"10th_percentile":279.59,"90th_percentile":279.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"87","median_amount":890.05,"10th_percentile":87.45,"90th_percentile":2543.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"211","median_amount":414.99,"10th_percentile":394.63,"90th_percentile":549.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Skin Procedures","code_information":[{"code":"5053","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":906.01,"10th_percentile":906.01,"90th_percentile":906.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"25","median_amount":614.2,"10th_percentile":614.2,"90th_percentile":771.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"34","median_amount":2472.0,"10th_percentile":2472.0,"90th_percentile":3518.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"32","median_amount":755.73,"10th_percentile":604.61,"90th_percentile":963.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"20","median_amount":2011.0,"10th_percentile":1948.0,"90th_percentile":2604.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":768.51,"10th_percentile":746.89,"90th_percentile":930.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":460.4,"10th_percentile":460.4,"90th_percentile":460.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":116.45,"10th_percentile":116.45,"90th_percentile":116.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":854.0,"10th_percentile":854.0,"90th_percentile":3191.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"47","median_amount":763.66,"10th_percentile":609.56,"90th_percentile":970.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Skin Procedures","code_information":[{"code":"5054","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4704.15,"10th_percentile":4704.15,"90th_percentile":4704.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2571.96,"10th_percentile":2571.96,"90th_percentile":2753.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":4367.06,"10th_percentile":4353.11,"90th_percentile":6866.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":1806.76,"10th_percentile":1806.76,"90th_percentile":1806.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2911.86,"10th_percentile":2911.86,"90th_percentile":2911.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":3214.0,"10th_percentile":3214.0,"90th_percentile":3423.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2110.9,"10th_percentile":2105.1,"90th_percentile":2461.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Skin Procedures","code_information":[{"code":"5055","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3734.43,"10th_percentile":3734.43,"90th_percentile":3734.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":4508.84,"10th_percentile":4508.84,"90th_percentile":4508.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3063.2,"10th_percentile":3063.2,"90th_percentile":3063.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":7200.0,"10th_percentile":5928.0,"90th_percentile":7856.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4758.64,"10th_percentile":4758.64,"90th_percentile":4758.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":33.34,"10th_percentile":33.34,"90th_percentile":33.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hyperbaric Oxygen","code_information":[{"code":"5061","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"65","median_amount":648.0,"10th_percentile":416.0,"90th_percentile":1128.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"26","median_amount":2400.0,"10th_percentile":2400.0,"90th_percentile":2400.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"15","median_amount":1900.0,"10th_percentile":1900.0,"90th_percentile":1900.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10315.09,"10th_percentile":10315.09,"90th_percentile":10315.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Excision/ Biopsy/ Incision and Drainage","code_information":[{"code":"5071","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"12","median_amount":3545.0,"10th_percentile":2527.28,"90th_percentile":3913.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":742.57,"10th_percentile":711.77,"90th_percentile":797.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"62","median_amount":2472.0,"10th_percentile":1878.2,"90th_percentile":3358.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":724.09,"10th_percentile":694.95,"90th_percentile":778.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"44","median_amount":2205.0,"10th_percentile":1696.0,"90th_percentile":2205.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"34","median_amount":741.57,"10th_percentile":711.87,"90th_percentile":830.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":625.41,"10th_percentile":625.41,"90th_percentile":625.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"24","median_amount":2491.0,"10th_percentile":2339.59,"90th_percentile":2990.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"25","median_amount":732.15,"10th_percentile":699.53,"90th_percentile":937.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Excision/ Biopsy/ Incision and Drainage","code_information":[{"code":"5072","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"47","median_amount":4594.0,"10th_percentile":1723.51,"90th_percentile":4824.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"60","median_amount":1722.61,"10th_percentile":1625.71,"90th_percentile":1810.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":3993.0,"10th_percentile":3993.0,"90th_percentile":3993.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"262","median_amount":4220.8,"10th_percentile":3046.16,"90th_percentile":6446.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"48","median_amount":1688.83,"10th_percentile":1600.34,"90th_percentile":1783.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"172","median_amount":3456.0,"10th_percentile":1696.0,"90th_percentile":4462.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":859.58,"10th_percentile":859.58,"90th_percentile":888.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"136","median_amount":1721.6,"10th_percentile":1631.61,"90th_percentile":1818.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":888.93,"10th_percentile":859.58,"90th_percentile":1171.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"119","median_amount":3423.0,"10th_percentile":3094.0,"90th_percentile":3878.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"67","median_amount":1690.46,"10th_percentile":1596.84,"90th_percentile":1778.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Excision/ Biopsy/ Incision and Drainage","code_information":[{"code":"5073","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":3024.26,"10th_percentile":350.0,"90th_percentile":5664.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":3017.26,"10th_percentile":2871.72,"90th_percentile":3025.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"36","median_amount":3797.48,"10th_percentile":1101.04,"90th_percentile":6970.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":2970.17,"10th_percentile":2826.9,"90th_percentile":2977.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"13","median_amount":2205.0,"10th_percentile":1696.0,"90th_percentile":5928.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"42","median_amount":3020.26,"10th_percentile":2872.12,"90th_percentile":3029.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3194.75,"10th_percentile":3194.75,"90th_percentile":3194.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1534.87,"10th_percentile":1534.87,"90th_percentile":1534.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1527.09,"10th_percentile":1527.09,"90th_percentile":2290.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":3423.0,"10th_percentile":3214.0,"90th_percentile":5539.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"22","median_amount":2960.11,"10th_percentile":2818.42,"90th_percentile":2988.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Breast/Lymphatic Surgery and Related Procedures","code_information":[{"code":"5091","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4662.97,"10th_percentile":4067.14,"90th_percentile":27533.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4074.07,"10th_percentile":395.0,"90th_percentile":6904.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"59","median_amount":5420.1,"10th_percentile":1605.19,"90th_percentile":22187.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":4007.53,"10th_percentile":3782.25,"90th_percentile":6883.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"43","median_amount":4462.0,"10th_percentile":3456.0,"90th_percentile":5564.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3587.77,"10th_percentile":3587.77,"90th_percentile":3587.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"41","median_amount":4135.74,"10th_percentile":3847.91,"90th_percentile":6904.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"28","median_amount":5896.7,"10th_percentile":648.0,"90th_percentile":12939.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"26","median_amount":4055.8,"10th_percentile":3987.73,"90th_percentile":6773.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Breast/Lymphatic Surgery and Related Procedures","code_information":[{"code":"5092","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":425.0,"10th_percentile":425.0,"90th_percentile":425.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":7997.03,"10th_percentile":4453.0,"90th_percentile":34660.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":7671.0,"10th_percentile":7671.0,"90th_percentile":32146.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7313.31,"10th_percentile":7290.74,"90th_percentile":7355.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":13006.98,"10th_percentile":13006.98,"90th_percentile":13006.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7135.41,"10th_percentile":6858.29,"90th_percentile":7383.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Breast/Lymphatic Surgery and Related Procedures","code_information":[{"code":"5093","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":1255.38,"10th_percentile":1255.38,"90th_percentile":4700.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":12094.8,"10th_percentile":12094.8,"90th_percentile":12094.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"13","median_amount":12041.11,"10th_percentile":6704.79,"90th_percentile":35790.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":36583.67,"10th_percentile":36583.67,"90th_percentile":36583.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":9096.71,"10th_percentile":7132.09,"90th_percentile":38530.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8497.07,"10th_percentile":8497.07,"90th_percentile":9607.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":26951.7,"10th_percentile":26951.7,"90th_percentile":26951.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8334.61,"10th_percentile":8334.61,"90th_percentile":8334.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Breast/Lymphatic Surgery and Related Procedures","code_information":[{"code":"5094","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":5641.44,"10th_percentile":5641.44,"90th_percentile":18038.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":39736.01,"10th_percentile":39736.01,"90th_percentile":39736.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"30","median_amount":26502.81,"10th_percentile":10780.35,"90th_percentile":37890.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":18248.69,"10th_percentile":18248.69,"90th_percentile":18248.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"16","median_amount":29813.95,"10th_percentile":9845.5,"90th_percentile":36803.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":15338.77,"10th_percentile":572.29,"90th_percentile":18055.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":15583.84,"10th_percentile":15389.0,"90th_percentile":42107.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":18476.93,"10th_percentile":17505.44,"90th_percentile":19239.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Strapping and Cast Application","code_information":[{"code":"5101","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":1131.0,"10th_percentile":1131.0,"90th_percentile":1131.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":321.87,"10th_percentile":321.87,"90th_percentile":321.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Strapping and Cast Application","code_information":[{"code":"5102","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":290.53,"10th_percentile":290.53,"90th_percentile":290.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":78.0,"10th_percentile":78.0,"90th_percentile":78.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":419.04,"10th_percentile":419.04,"90th_percentile":419.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Musculoskeletal Procedures","code_information":[{"code":"5111","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":2301.0,"10th_percentile":2301.0,"90th_percentile":6316.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":508.57,"10th_percentile":508.57,"90th_percentile":508.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":508.57,"10th_percentile":508.57,"90th_percentile":508.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":409.38,"10th_percentile":409.38,"90th_percentile":409.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Musculoskeletal Procedures","code_information":[{"code":"5112","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":1405.75,"10th_percentile":1342.52,"90th_percentile":4874.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1679.11,"10th_percentile":1679.11,"90th_percentile":1679.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":6418.47,"10th_percentile":6393.0,"90th_percentile":6426.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":1570.0,"10th_percentile":1570.0,"90th_percentile":2604.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1672.59,"10th_percentile":1608.22,"90th_percentile":1810.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":508.57,"10th_percentile":508.57,"90th_percentile":508.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":858.15,"10th_percentile":858.15,"90th_percentile":858.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":1624.0,"10th_percentile":1582.0,"90th_percentile":4821.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1762.44,"10th_percentile":1762.44,"90th_percentile":1762.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Musculoskeletal Procedures","code_information":[{"code":"5113","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":7133.45,"10th_percentile":7133.45,"90th_percentile":7133.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3456.8,"10th_percentile":3456.8,"90th_percentile":3456.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":12048.0,"10th_percentile":12048.0,"90th_percentile":12048.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":4417.88,"10th_percentile":451.22,"90th_percentile":9669.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3345.74,"10th_percentile":3345.74,"90th_percentile":3345.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":6850.88,"10th_percentile":6664.01,"90th_percentile":7671.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":43.19,"10th_percentile":43.19,"90th_percentile":43.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3405.78,"10th_percentile":3405.78,"90th_percentile":3405.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1841.93,"10th_percentile":1841.93,"90th_percentile":1841.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3543.95,"10th_percentile":3543.95,"90th_percentile":3543.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":9146.5,"10th_percentile":8197.0,"90th_percentile":23960.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3518.58,"10th_percentile":3339.9,"90th_percentile":12795.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Musculoskeletal Procedures","code_information":[{"code":"5114","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":7728.2,"10th_percentile":1835.48,"90th_percentile":15416.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7751.52,"10th_percentile":7549.4,"90th_percentile":10196.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"61","median_amount":6631.02,"10th_percentile":3140.28,"90th_percentile":14109.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8038.0,"10th_percentile":7345.71,"90th_percentile":9747.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"40","median_amount":9780.03,"10th_percentile":4798.69,"90th_percentile":16618.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":3543.95,"10th_percentile":3543.95,"90th_percentile":3543.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"26","median_amount":7543.37,"10th_percentile":7167.86,"90th_percentile":8128.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4515.9,"10th_percentile":3543.95,"90th_percentile":4895.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"15","median_amount":3543.95,"10th_percentile":2516.64,"90th_percentile":4890.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"27","median_amount":15327.7,"10th_percentile":7581.48,"90th_percentile":19473.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"15","median_amount":7490.04,"10th_percentile":7230.18,"90th_percentile":7962.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Musculoskeletal Procedures","code_information":[{"code":"5115","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"11","median_amount":13543.85,"10th_percentile":5566.21,"90th_percentile":14253.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"66","median_amount":13536.87,"10th_percentile":13093.63,"90th_percentile":13919.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"96","median_amount":9860.56,"10th_percentile":6613.54,"90th_percentile":20281.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"22","median_amount":13230.36,"10th_percentile":12807.93,"90th_percentile":13707.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"58","median_amount":8381.0,"10th_percentile":7410.0,"90th_percentile":13519.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"94","median_amount":13538.73,"10th_percentile":3297.37,"90th_percentile":13923.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3543.95,"10th_percentile":3543.95,"90th_percentile":3543.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5957.97,"10th_percentile":5957.97,"90th_percentile":5957.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"33","median_amount":19188.98,"10th_percentile":18446.71,"90th_percentile":20139.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"95","median_amount":13275.36,"10th_percentile":371.38,"90th_percentile":13653.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 6 Musculoskeletal Procedures","code_information":[{"code":"5116","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":14991.57,"10th_percentile":3850.0,"90th_percentile":29108.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"27","median_amount":18600.79,"10th_percentile":18394.73,"90th_percentile":18853.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"23","median_amount":14916.86,"10th_percentile":4811.59,"90th_percentile":27257.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":18310.3,"10th_percentile":18209.62,"90th_percentile":18746.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"17","median_amount":12189.0,"10th_percentile":4237.0,"90th_percentile":15306.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"35","median_amount":18608.57,"10th_percentile":18217.11,"90th_percentile":19029.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"17","median_amount":22698.82,"10th_percentile":16935.5,"90th_percentile":44492.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"42","median_amount":18239.08,"10th_percentile":18049.43,"90th_percentile":18446.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 7 Musculoskeletal Procedures","code_information":[{"code":"5117","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":18642.77,"10th_percentile":13274.29,"90th_percentile":28915.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":28311.56,"10th_percentile":28311.56,"90th_percentile":28311.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":14729.0,"10th_percentile":14729.0,"90th_percentile":14729.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":28754.09,"10th_percentile":28687.48,"90th_percentile":28789.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4890.44,"10th_percentile":4890.44,"90th_percentile":4890.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":37820.75,"10th_percentile":37820.75,"90th_percentile":37820.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":28258.09,"10th_percentile":28258.09,"90th_percentile":28258.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Airway Endoscopy","code_information":[{"code":"5151","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":418.0,"10th_percentile":418.0,"90th_percentile":418.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":211.57,"10th_percentile":211.57,"90th_percentile":211.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":418.0,"10th_percentile":418.0,"90th_percentile":418.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":207.42,"10th_percentile":207.42,"90th_percentile":207.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Airway Endoscopy","code_information":[{"code":"5153","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4617.62,"10th_percentile":4617.62,"90th_percentile":4636.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1856.75,"10th_percentile":395.0,"90th_percentile":3850.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"13","median_amount":4178.24,"10th_percentile":3047.05,"90th_percentile":6405.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1820.0,"10th_percentile":1820.0,"90th_percentile":1820.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":3016.5,"10th_percentile":3016.5,"90th_percentile":3016.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1854.86,"10th_percentile":1733.3,"90th_percentile":1858.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1323.35,"10th_percentile":1323.35,"90th_percentile":1323.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":3423.0,"10th_percentile":3214.0,"90th_percentile":8595.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":1817.61,"10th_percentile":1693.44,"90th_percentile":1823.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Airway Endoscopy","code_information":[{"code":"5154","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":350.0,"10th_percentile":350.0,"90th_percentile":350.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":3845.43,"10th_percentile":303.16,"90th_percentile":7433.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"17","median_amount":4402.88,"10th_percentile":4390.32,"90th_percentile":9620.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":3727.4,"10th_percentile":1820.84,"90th_percentile":6923.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":7436.25,"10th_percentile":5928.0,"90th_percentile":9682.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"26","median_amount":3980.36,"10th_percentile":3877.81,"90th_percentile":7427.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":5896.0,"10th_percentile":2323.21,"90th_percentile":9942.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"15","median_amount":3807.88,"10th_percentile":550.0,"90th_percentile":7278.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Airway Endoscopy","code_information":[{"code":"5155","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":7480.21,"10th_percentile":7480.21,"90th_percentile":7480.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7332.91,"10th_percentile":7332.91,"90th_percentile":7332.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":4410.52,"10th_percentile":1110.13,"90th_percentile":9739.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7216.5,"10th_percentile":7216.5,"90th_percentile":7252.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":6415.0,"10th_percentile":4964.25,"90th_percentile":13212.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":7331.3,"10th_percentile":225.0,"90th_percentile":7337.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":10965.0,"10th_percentile":10965.0,"90th_percentile":12295.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7198.17,"10th_percentile":6817.07,"90th_percentile":7201.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 ENT Procedures","code_information":[{"code":"5163","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":4462.0,"10th_percentile":4462.0,"90th_percentile":4462.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1496.12,"10th_percentile":1496.12,"90th_percentile":1496.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 ENT Procedures","code_information":[{"code":"5164","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":5436.97,"10th_percentile":5436.97,"90th_percentile":5436.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":5440.0,"10th_percentile":5276.0,"90th_percentile":7558.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":7143.0,"10th_percentile":3214.0,"90th_percentile":8704.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 ENT Procedures","code_information":[{"code":"5165","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6149.2,"10th_percentile":395.0,"90th_percentile":7079.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"16","median_amount":11548.68,"10th_percentile":9631.31,"90th_percentile":18152.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5843.01,"10th_percentile":5843.01,"90th_percentile":6086.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"11","median_amount":5826.0,"10th_percentile":4304.0,"90th_percentile":7524.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6156.2,"10th_percentile":6155.2,"90th_percentile":6160.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":12276.0,"10th_percentile":11362.0,"90th_percentile":13437.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5819.26,"10th_percentile":5819.26,"90th_percentile":6037.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cochlear Implant Procedure","code_information":[{"code":"5166","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":7729.0,"10th_percentile":7729.0,"90th_percentile":7729.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Vascular Procedures","code_information":[{"code":"5181","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4184.17,"10th_percentile":3125.34,"90th_percentile":4594.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":749.91,"10th_percentile":659.51,"90th_percentile":1471.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"18","median_amount":2380.0,"10th_percentile":2192.21,"90th_percentile":2920.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"17","median_amount":657.78,"10th_percentile":150.0,"90th_percentile":1200.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":1948.0,"10th_percentile":1948.0,"90th_percentile":2205.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"50","median_amount":657.61,"10th_percentile":620.35,"90th_percentile":797.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":2653.0,"10th_percentile":2394.0,"90th_percentile":2653.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":727.47,"10th_percentile":608.19,"90th_percentile":1337.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Vascular Procedures","code_information":[{"code":"5182","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":3581.01,"10th_percentile":1165.72,"90th_percentile":10205.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1568.87,"10th_percentile":290.0,"90th_percentile":1645.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"43","median_amount":3055.04,"10th_percentile":2623.27,"90th_percentile":4167.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1609.62,"10th_percentile":1534.36,"90th_percentile":1635.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":2205.0,"10th_percentile":1696.0,"90th_percentile":3629.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":1635.15,"10th_percentile":1559.09,"90th_percentile":1642.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":488.63,"10th_percentile":488.63,"90th_percentile":488.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":754.57,"10th_percentile":754.57,"90th_percentile":893.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"11","median_amount":3214.0,"10th_percentile":854.0,"90th_percentile":3423.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":1603.69,"10th_percentile":1603.09,"90th_percentile":1614.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Vascular Procedures","code_information":[{"code":"5183","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4618.96,"10th_percentile":4604.95,"90th_percentile":4836.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":3286.81,"10th_percentile":3279.81,"90th_percentile":3295.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"38","median_amount":4185.12,"10th_percentile":3712.52,"90th_percentile":5142.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":3228.63,"10th_percentile":3108.85,"90th_percentile":3244.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"24","median_amount":3456.0,"10th_percentile":3456.0,"90th_percentile":5564.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"54","median_amount":3280.21,"10th_percentile":3158.14,"90th_percentile":3286.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"21","median_amount":5812.77,"10th_percentile":4718.34,"90th_percentile":6065.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"23","median_amount":3219.08,"10th_percentile":3096.22,"90th_percentile":3226.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Vascular Procedures","code_information":[{"code":"5184","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4636.03,"10th_percentile":4636.03,"90th_percentile":4636.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5429.76,"10th_percentile":5429.76,"90th_percentile":5429.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"16","median_amount":5396.0,"10th_percentile":2156.07,"90th_percentile":7590.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5339.31,"10th_percentile":5339.31,"90th_percentile":5689.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":9893.3,"10th_percentile":9893.3,"90th_percentile":9893.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5423.96,"10th_percentile":2896.04,"90th_percentile":5787.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":19587.0,"10th_percentile":19587.0,"90th_percentile":19587.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5666.76,"10th_percentile":5666.76,"90th_percentile":5675.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Endovascular Procedures","code_information":[{"code":"5191","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":10436.22,"10th_percentile":9106.69,"90th_percentile":11559.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"35","median_amount":3374.54,"10th_percentile":3233.08,"90th_percentile":5912.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"65","median_amount":10298.57,"10th_percentile":3314.99,"90th_percentile":12866.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":3314.99,"10th_percentile":3176.91,"90th_percentile":5819.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"21","median_amount":8540.0,"10th_percentile":8540.0,"90th_percentile":10289.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"58","median_amount":3373.54,"10th_percentile":3233.18,"90th_percentile":5726.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"15","median_amount":11362.0,"10th_percentile":10669.0,"90th_percentile":11362.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"32","median_amount":3310.02,"10th_percentile":3167.0,"90th_percentile":5619.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Endovascular Procedures","code_information":[{"code":"5192","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":10521.47,"10th_percentile":10521.47,"90th_percentile":10521.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5963.09,"10th_percentile":5963.09,"90th_percentile":5963.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":9602.65,"10th_percentile":5400.06,"90th_percentile":16331.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5631.5,"10th_percentile":5631.5,"90th_percentile":5631.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5726.68,"10th_percentile":5723.28,"90th_percentile":5919.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5807.18,"10th_percentile":5807.18,"90th_percentile":5807.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Endovascular Procedures","code_information":[{"code":"5193","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":11421.32,"10th_percentile":5636.81,"90th_percentile":12101.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":12006.86,"10th_percentile":11991.48,"90th_percentile":12113.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"24","median_amount":19005.13,"10th_percentile":5469.12,"90th_percentile":25242.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":11804.33,"10th_percentile":11214.48,"90th_percentile":12353.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":8540.0,"10th_percentile":3266.0,"90th_percentile":8540.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"36","median_amount":11998.49,"10th_percentile":11384.79,"90th_percentile":12021.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":20041.85,"10th_percentile":16836.5,"90th_percentile":23142.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"17","median_amount":11741.4,"10th_percentile":11158.58,"90th_percentile":11780.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Endovascular Procedures","code_information":[{"code":"5194","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":8593.72,"10th_percentile":8593.72,"90th_percentile":8593.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":25903.65,"10th_percentile":25903.65,"90th_percentile":25903.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":20888.0,"10th_percentile":20888.0,"90th_percentile":20888.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":19047.92,"10th_percentile":18030.78,"90th_percentile":19048.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":26408.89,"10th_percentile":26408.89,"90th_percentile":26408.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":18677.05,"10th_percentile":18677.05,"90th_percentile":18677.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Electrophysiologic Procedures","code_information":[{"code":"5212","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":18269.7,"10th_percentile":18269.7,"90th_percentile":18269.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":8540.0,"10th_percentile":8540.0,"90th_percentile":8540.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8102.27,"10th_percentile":8102.27,"90th_percentile":8102.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":9493.0,"10th_percentile":6835.55,"90th_percentile":14880.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7943.11,"10th_percentile":7943.11,"90th_percentile":7943.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Electrophysiologic Procedures","code_information":[{"code":"5213","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":31105.47,"10th_percentile":27152.59,"90th_percentile":146066.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"41","median_amount":27151.59,"10th_percentile":24615.18,"90th_percentile":27172.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"69","median_amount":18295.93,"10th_percentile":16325.69,"90th_percentile":23239.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":26726.87,"10th_percentile":24231.03,"90th_percentile":27267.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"32","median_amount":8540.0,"10th_percentile":8540.0,"90th_percentile":10289.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"58","median_amount":27156.61,"10th_percentile":24621.08,"90th_percentile":27259.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":11098.19,"10th_percentile":11098.19,"90th_percentile":11098.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"24","median_amount":17895.0,"10th_percentile":1288.82,"90th_percentile":26160.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"42","median_amount":26623.25,"10th_percentile":24135.53,"90th_percentile":26640.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Pacemaker and Similar Procedures","code_information":[{"code":"5222","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8602.52,"10th_percentile":8596.22,"90th_percentile":8603.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":10273.25,"10th_percentile":6804.2,"90th_percentile":14473.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8503.55,"10th_percentile":8503.55,"90th_percentile":8649.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":5539.0,"10th_percentile":5539.0,"90th_percentile":5539.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":8602.03,"10th_percentile":8309.94,"90th_percentile":8611.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":19491.5,"10th_percentile":19491.5,"90th_percentile":36578.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8432.99,"10th_percentile":8432.99,"90th_percentile":8432.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Pacemaker and Similar Procedures","code_information":[{"code":"5223","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"15","median_amount":10858.97,"10th_percentile":10519.88,"90th_percentile":10932.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":9396.38,"10th_percentile":8932.79,"90th_percentile":13999.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10687.53,"10th_percentile":10687.53,"90th_percentile":10687.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":7882.05,"10th_percentile":7882.05,"90th_percentile":7882.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":10857.38,"10th_percentile":10506.59,"90th_percentile":10873.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10298.66,"10th_percentile":2172.26,"90th_percentile":10653.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Pacemaker and Similar Procedures","code_information":[{"code":"5224","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":20025.72,"10th_percentile":20025.72,"90th_percentile":20025.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":20015.01,"10th_percentile":19145.43,"90th_percentile":20188.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":19626.7,"10th_percentile":18760.39,"90th_percentile":19656.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 ICD and Similar Procedures","code_information":[{"code":"5231","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":20159.61,"10th_percentile":20159.61,"90th_percentile":21152.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":22744.83,"10th_percentile":22744.83,"90th_percentile":22744.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":26576.51,"10th_percentile":26576.51,"90th_percentile":26576.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":8964.8,"10th_percentile":8964.8,"90th_percentile":8964.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":19383.66,"10th_percentile":19383.66,"90th_percentile":19383.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":22652.39,"10th_percentile":22652.39,"90th_percentile":22652.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 ICD and Similar Procedures","code_information":[{"code":"5232","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":419.74,"10th_percentile":419.74,"90th_percentile":419.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":32605.04,"10th_percentile":32605.04,"90th_percentile":32605.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":22957.11,"10th_percentile":20817.13,"90th_percentile":25443.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":32254.27,"10th_percentile":32254.27,"90th_percentile":32618.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":23301.68,"10th_percentile":23301.68,"90th_percentile":23301.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":32605.46,"10th_percentile":32313.0,"90th_percentile":32623.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":32177.76,"10th_percentile":32177.76,"90th_percentile":32177.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":34496.7,"10th_percentile":34496.7,"90th_percentile":34496.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":31969.65,"10th_percentile":31969.65,"90th_percentile":31969.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Blood Product Exchange and Related Services","code_information":[{"code":"5241","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":1995.04,"10th_percentile":1995.04,"90th_percentile":1995.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":826.14,"10th_percentile":694.36,"90th_percentile":4822.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"31","median_amount":1905.98,"10th_percentile":1641.0,"90th_percentile":2411.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":1030.74,"10th_percentile":632.18,"90th_percentile":14123.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"17","median_amount":1570.0,"10th_percentile":889.44,"90th_percentile":4237.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"130","median_amount":697.2,"10th_percentile":620.59,"90th_percentile":1041.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1722.08,"10th_percentile":1722.08,"90th_percentile":1722.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":368.31,"10th_percentile":368.31,"90th_percentile":368.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":630.02,"10th_percentile":630.02,"90th_percentile":630.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":353.0,"10th_percentile":81.4,"90th_percentile":1274.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"17","median_amount":850.13,"10th_percentile":608.42,"90th_percentile":3142.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Upper GI Procedures","code_information":[{"code":"5301","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"21","median_amount":4594.0,"10th_percentile":2084.6,"90th_percentile":4609.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"29","median_amount":950.03,"10th_percentile":940.72,"90th_percentile":2316.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"118","median_amount":2476.28,"10th_percentile":1996.0,"90th_percentile":3863.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"23","median_amount":932.0,"10th_percentile":927.43,"90th_percentile":2139.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"48","median_amount":2604.0,"10th_percentile":1696.0,"90th_percentile":3016.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":648.98,"10th_percentile":648.98,"90th_percentile":648.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"77","median_amount":949.13,"10th_percentile":941.12,"90th_percentile":1664.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":869.67,"10th_percentile":869.67,"90th_percentile":869.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"12","median_amount":648.98,"10th_percentile":648.98,"90th_percentile":821.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"40","median_amount":3423.0,"10th_percentile":2891.83,"90th_percentile":4821.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"47","median_amount":932.16,"10th_percentile":922.68,"90th_percentile":2027.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Upper GI Procedures","code_information":[{"code":"5302","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4606.85,"10th_percentile":4598.28,"90th_percentile":4839.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":1993.25,"10th_percentile":1907.33,"90th_percentile":2004.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"28","median_amount":4335.93,"10th_percentile":3432.44,"90th_percentile":6859.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1873.69,"10th_percentile":1873.69,"90th_percentile":1962.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"12","median_amount":3906.0,"10th_percentile":2604.0,"90th_percentile":4557.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1993.65,"10th_percentile":1905.9,"90th_percentile":2016.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":4821.0,"10th_percentile":1959.67,"90th_percentile":5134.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"21","median_amount":1962.02,"10th_percentile":1868.61,"90th_percentile":1965.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Upper GI Procedures","code_information":[{"code":"5303","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":5417.34,"10th_percentile":5417.34,"90th_percentile":5417.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4116.36,"10th_percentile":4116.36,"90th_percentile":4116.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3817.78,"10th_percentile":3817.78,"90th_percentile":3817.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3937.34,"10th_percentile":3937.34,"90th_percentile":3937.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Lower GI Procedures","code_information":[{"code":"5311","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4608.76,"10th_percentile":1376.12,"90th_percentile":6797.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":970.75,"10th_percentile":914.79,"90th_percentile":1437.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"52","median_amount":2480.41,"10th_percentile":2005.34,"90th_percentile":3865.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":950.92,"10th_percentile":950.92,"90th_percentile":2181.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"15","median_amount":2604.0,"10th_percentile":2011.0,"90th_percentile":3906.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1437.47,"10th_percentile":969.92,"90th_percentile":3104.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"23","median_amount":3423.0,"10th_percentile":3214.0,"90th_percentile":5134.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"36","median_amount":947.05,"10th_percentile":896.86,"90th_percentile":1408.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Lower GI Procedures","code_information":[{"code":"5312","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"22","median_amount":4611.14,"10th_percentile":4047.01,"90th_percentile":4837.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"21","median_amount":1249.13,"10th_percentile":1183.07,"90th_percentile":1774.61,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":3633.0,"10th_percentile":3633.0,"90th_percentile":3633.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"96","median_amount":3830.66,"10th_percentile":2863.86,"90th_percentile":6088.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"24","median_amount":1687.31,"10th_percentile":1168.47,"90th_percentile":1844.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"35","median_amount":3519.25,"10th_percentile":2604.0,"90th_percentile":4496.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":636.88,"10th_percentile":636.88,"90th_percentile":636.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"38","median_amount":1246.93,"10th_percentile":1183.07,"90th_percentile":1742.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1320.28,"10th_percentile":1320.28,"90th_percentile":1320.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":636.88,"10th_percentile":636.88,"90th_percentile":636.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"36","median_amount":3423.0,"10th_percentile":3214.0,"90th_percentile":5134.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"70","median_amount":1627.64,"10th_percentile":1159.87,"90th_percentile":2293.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Lower GI Procedures","code_information":[{"code":"5313","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":4493.0,"10th_percentile":4115.39,"90th_percentile":6986.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":3456.0,"10th_percentile":3456.0,"90th_percentile":3456.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":5896.0,"10th_percentile":5896.0,"90th_percentile":5896.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Complex GI Procedures","code_information":[{"code":"5331","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6312.12,"10th_percentile":6312.12,"90th_percentile":6312.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6193.48,"10th_percentile":6193.48,"90th_percentile":6193.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Abdominal/Peritoneal/Biliary and Related Procedures","code_information":[{"code":"5341","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3719.13,"10th_percentile":3719.13,"90th_percentile":3719.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"12","median_amount":5423.58,"10th_percentile":3812.24,"90th_percentile":9645.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3870.48,"10th_percentile":3870.48,"90th_percentile":3870.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":5928.0,"10th_percentile":4209.0,"90th_percentile":7729.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":3724.13,"10th_percentile":3543.78,"90th_percentile":3726.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3655.18,"10th_percentile":3655.18,"90th_percentile":3655.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":13501.98,"10th_percentile":13501.98,"90th_percentile":13501.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3646.21,"10th_percentile":3471.56,"90th_percentile":3857.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Abdominal/Peritoneal/Biliary and Related Procedures","code_information":[{"code":"5342","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":5396.48,"10th_percentile":5396.48,"90th_percentile":5396.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1668.53,"10th_percentile":1668.53,"90th_percentile":1668.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":3560.7,"10th_percentile":3560.7,"90th_percentile":4493.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":6498.4,"10th_percentile":6498.4,"90th_percentile":6498.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6732.98,"10th_percentile":6730.66,"90th_percentile":6898.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":15517.53,"10th_percentile":15517.53,"90th_percentile":15517.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6593.39,"10th_percentile":6593.39,"90th_percentile":6593.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Laparoscopy and Related Services","code_information":[{"code":"5361","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"33","median_amount":4858.66,"10th_percentile":2433.7,"90th_percentile":6047.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"27","median_amount":6286.77,"10th_percentile":5859.87,"90th_percentile":7269.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":5751.08,"10th_percentile":5751.08,"90th_percentile":5751.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"189","median_amount":5443.83,"10th_percentile":1489.59,"90th_percentile":10050.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"19","median_amount":6181.76,"10th_percentile":5762.71,"90th_percentile":10869.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"94","median_amount":5826.0,"10th_percentile":4209.0,"90th_percentile":8057.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4209.0,"10th_percentile":4209.0,"90th_percentile":4209.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":4285.77,"10th_percentile":3418.13,"90th_percentile":4285.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"43","median_amount":6286.77,"10th_percentile":6280.17,"90th_percentile":7692.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":14769.5,"10th_percentile":14769.5,"90th_percentile":14769.5},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6265.11,"10th_percentile":6265.11,"90th_percentile":6265.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6212.9,"10th_percentile":6212.9,"90th_percentile":6212.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3348.64,"10th_percentile":2857.18,"90th_percentile":4485.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"88","median_amount":13058.0,"10th_percentile":11981.76,"90th_percentile":19587.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"63","median_amount":6162.33,"10th_percentile":5739.29,"90th_percentile":6176.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Laparoscopy and Related Services","code_information":[{"code":"5362","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"12","median_amount":4745.48,"10th_percentile":4497.41,"90th_percentile":4896.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":11050.27,"10th_percentile":10452.8,"90th_percentile":11247.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"97","median_amount":5431.51,"10th_percentile":2121.94,"90th_percentile":9675.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10922.9,"10th_percentile":10922.9,"90th_percentile":10922.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"56","median_amount":7729.0,"10th_percentile":5928.0,"90th_percentile":9682.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"33","median_amount":11049.27,"10th_percentile":10452.29,"90th_percentile":11238.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":10553.18,"10th_percentile":10553.18,"90th_percentile":10553.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5608.12,"10th_percentile":5608.12,"90th_percentile":5608.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"38","median_amount":13058.72,"10th_percentile":5334.5,"90th_percentile":19587.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":10834.72,"10th_percentile":466.14,"90th_percentile":10888.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Urology and Related Services","code_information":[{"code":"5371","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":255.48,"10th_percentile":255.48,"90th_percentile":255.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":1282.97,"10th_percentile":1282.97,"90th_percentile":1282.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":407.43,"10th_percentile":407.43,"90th_percentile":407.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":115.26,"10th_percentile":115.26,"90th_percentile":115.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Urology and Related Services","code_information":[{"code":"5372","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":726.32,"10th_percentile":669.72,"90th_percentile":726.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"15","median_amount":748.31,"10th_percentile":140.48,"90th_percentile":1734.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"17","median_amount":713.02,"10th_percentile":659.27,"90th_percentile":713.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":1696.0,"10th_percentile":1696.0,"90th_percentile":1696.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"34","median_amount":731.32,"10th_percentile":609.0,"90th_percentile":731.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":2653.0,"10th_percentile":2653.0,"90th_percentile":2653.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":712.56,"10th_percentile":656.6,"90th_percentile":1875.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Urology and Related Services","code_information":[{"code":"5373","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4621.32,"10th_percentile":4621.32,"90th_percentile":4621.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":2156.8,"10th_percentile":2055.43,"90th_percentile":2179.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"25","median_amount":3514.21,"10th_percentile":956.85,"90th_percentile":6864.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2023.35,"10th_percentile":2023.35,"90th_percentile":2023.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"15","median_amount":2011.0,"10th_percentile":2011.0,"90th_percentile":2604.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":2171.39,"10th_percentile":2055.43,"90th_percentile":2178.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"11","median_amount":3214.0,"10th_percentile":3096.76,"90th_percentile":5896.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":2137.31,"10th_percentile":2015.13,"90th_percentile":2141.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Urology and Related Services","code_information":[{"code":"5374","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"14","median_amount":4618.3,"10th_percentile":1100.82,"90th_percentile":4871.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"21","median_amount":3661.55,"10th_percentile":653.94,"90th_percentile":3686.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"52","median_amount":5410.0,"10th_percentile":1360.21,"90th_percentile":9628.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":3604.41,"10th_percentile":3406.62,"90th_percentile":3990.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"21","median_amount":4237.0,"10th_percentile":1696.0,"90th_percentile":6355.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"30","median_amount":3667.11,"10th_percentile":3470.45,"90th_percentile":3669.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":5896.0,"10th_percentile":5896.0,"90th_percentile":14384.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"17","median_amount":3589.76,"10th_percentile":3396.63,"90th_percentile":3780.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Urology and Related Services","code_information":[{"code":"5375","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4643.91,"10th_percentile":4624.5,"90th_percentile":5412.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":5108.7,"10th_percentile":5100.8,"90th_percentile":5604.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"40","median_amount":5538.94,"10th_percentile":3963.51,"90th_percentile":9781.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5025.06,"10th_percentile":5021.19,"90th_percentile":5509.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"17","median_amount":5928.0,"10th_percentile":5214.5,"90th_percentile":7729.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":2722.89,"10th_percentile":2722.89,"90th_percentile":2722.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":5575.56,"10th_percentile":5112.53,"90th_percentile":5579.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"12","median_amount":10669.0,"10th_percentile":2402.0,"90th_percentile":11683.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":5464.25,"10th_percentile":5006.69,"90th_percentile":5523.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 6 Urology and Related Services","code_information":[{"code":"5376","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4626.03,"10th_percentile":1312.43,"90th_percentile":4637.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9288.46,"10th_percentile":9283.89,"90th_percentile":9833.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"24","median_amount":4404.54,"10th_percentile":1373.34,"90th_percentile":5531.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9679.79,"10th_percentile":9679.79,"90th_percentile":9735.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":5928.0,"10th_percentile":3266.0,"90th_percentile":8892.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":9839.25,"10th_percentile":9284.29,"90th_percentile":9841.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":8844.0,"10th_percentile":8844.0,"90th_percentile":8844.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":9648.95,"10th_percentile":9115.03,"90th_percentile":9655.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 7 Urology and Related Services","code_information":[{"code":"5377","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":23382.0,"10th_percentile":23382.0,"90th_percentile":23382.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 8 Urology and Related Services","code_information":[{"code":"5378","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":86183.31,"10th_percentile":86183.31,"90th_percentile":86183.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Dialysis","code_information":[{"code":"5401","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1458.65,"10th_percentile":1332.26,"90th_percentile":1506.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Gynecologic Procedures","code_information":[{"code":"5411","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"35","median_amount":866.0,"10th_percentile":758.0,"90th_percentile":909.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":715.8,"10th_percentile":715.8,"90th_percentile":1650.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"129","median_amount":1797.0,"10th_percentile":827.89,"90th_percentile":2614.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2643.0,"10th_percentile":2643.0,"90th_percentile":2643.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"82","median_amount":1265.0,"10th_percentile":1131.0,"90th_percentile":1360.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":266.37,"10th_percentile":266.37,"90th_percentile":266.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"30","median_amount":295.35,"10th_percentile":291.31,"90th_percentile":310.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":315.74,"10th_percentile":315.74,"90th_percentile":315.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"74","median_amount":295.35,"10th_percentile":161.29,"90th_percentile":310.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"66","median_amount":1056.0,"10th_percentile":501.69,"90th_percentile":1170.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Gynecologic Procedures","code_information":[{"code":"5412","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":3617.67,"10th_percentile":2573.85,"90th_percentile":3621.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Gynecologic Procedures","code_information":[{"code":"5413","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":2021.38,"10th_percentile":2021.38,"90th_percentile":2021.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Gynecologic Procedures","code_information":[{"code":"5414","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4658.88,"10th_percentile":4622.22,"90th_percentile":20180.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3362.55,"10th_percentile":3190.88,"90th_percentile":3369.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"71","median_amount":4395.57,"10th_percentile":2047.43,"90th_percentile":6995.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3140.49,"10th_percentile":3140.49,"90th_percentile":3140.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"39","median_amount":4462.0,"10th_percentile":2604.0,"90th_percentile":5826.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1209.21,"10th_percentile":1209.21,"90th_percentile":1209.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"21","median_amount":3363.62,"10th_percentile":3193.27,"90th_percentile":3549.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":15292.96,"10th_percentile":15292.96,"90th_percentile":15292.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1564.38,"10th_percentile":1564.38,"90th_percentile":1564.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1209.21,"10th_percentile":1209.21,"90th_percentile":1209.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"29","median_amount":5675.0,"10th_percentile":5329.0,"90th_percentile":6217.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3307.62,"10th_percentile":3297.02,"90th_percentile":3487.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Gynecologic Procedures","code_information":[{"code":"5415","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4606.51,"10th_percentile":3537.36,"90th_percentile":6478.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":4960.15,"10th_percentile":4960.15,"90th_percentile":4960.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"20","median_amount":5428.17,"10th_percentile":1121.27,"90th_percentile":9635.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"17","median_amount":5772.84,"10th_percentile":3456.0,"90th_percentile":7918.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5203.66,"10th_percentile":5197.64,"90th_percentile":5218.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"12","median_amount":8730.0,"10th_percentile":8197.7,"90th_percentile":8730.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":5105.4,"10th_percentile":5100.97,"90th_percentile":7305.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 6 Gynecologic Procedures","code_information":[{"code":"5416","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":206.1,"10th_percentile":206.1,"90th_percentile":206.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":11555.68,"10th_percentile":11555.68,"90th_percentile":11555.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7445.0,"10th_percentile":7445.0,"90th_percentile":7703.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7283.05,"10th_percentile":7283.05,"90th_percentile":7298.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Nerve Procedures","code_information":[{"code":"5431","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2035.38,"10th_percentile":2035.38,"90th_percentile":2035.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":6843.1,"10th_percentile":6843.1,"90th_percentile":6843.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1996.73,"10th_percentile":1996.73,"90th_percentile":1996.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1971.9,"10th_percentile":1971.9,"90th_percentile":1971.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1999.94,"10th_percentile":1999.94,"90th_percentile":1999.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Nerve Procedures","code_information":[{"code":"5432","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6430.71,"10th_percentile":6430.71,"90th_percentile":6430.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Nerve Injections","code_information":[{"code":"5441","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":1742.1,"10th_percentile":301.92,"90th_percentile":4642.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"23","median_amount":318.84,"10th_percentile":301.27,"90th_percentile":604.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":4795.32,"10th_percentile":4795.32,"90th_percentile":4795.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"24","median_amount":2511.54,"10th_percentile":1802.76,"90th_percentile":2970.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":313.87,"10th_percentile":296.25,"90th_percentile":470.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":2205.0,"10th_percentile":1377.94,"90th_percentile":2921.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"28","median_amount":324.84,"10th_percentile":306.86,"90th_percentile":484.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":910.0,"10th_percentile":910.0,"90th_percentile":1365.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":315.6,"10th_percentile":312.6,"90th_percentile":478.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Nerve Injections","code_information":[{"code":"5442","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":1940.84,"10th_percentile":1332.0,"90th_percentile":4605.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"20","median_amount":740.24,"10th_percentile":705.42,"90th_percentile":1425.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"34","median_amount":2327.37,"10th_percentile":494.93,"90th_percentile":3853.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":721.79,"10th_percentile":688.7,"90th_percentile":1082.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"17","median_amount":2205.0,"10th_percentile":1592.95,"90th_percentile":2544.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"35","median_amount":739.24,"10th_percentile":705.52,"90th_percentile":1056.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":526.34,"10th_percentile":526.34,"90th_percentile":526.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1024.8,"10th_percentile":1024.8,"90th_percentile":1024.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":2653.0,"10th_percentile":2491.0,"90th_percentile":2921.94,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":728.56,"10th_percentile":693.57,"90th_percentile":1039.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Nerve Injections","code_information":[{"code":"5443","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":4632.63,"10th_percentile":1345.74,"90th_percentile":4832.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":1349.46,"10th_percentile":918.74,"90th_percentile":2304.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"25","median_amount":2486.14,"10th_percentile":1998.16,"90th_percentile":3861.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":1356.6,"10th_percentile":1226.05,"90th_percentile":1363.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":2205.0,"10th_percentile":1696.0,"90th_percentile":5426.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"37","median_amount":925.74,"10th_percentile":840.87,"90th_percentile":1384.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":3979.5,"10th_percentile":3108.0,"90th_percentile":3979.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"22","median_amount":1316.37,"10th_percentile":901.13,"90th_percentile":1359.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Neurostimulator and Related Procedures","code_information":[{"code":"5461","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":3650.31,"10th_percentile":3646.39,"90th_percentile":3857.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Neurostimulator and Related Procedures","code_information":[{"code":"5462","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":6693.0,"10th_percentile":6693.0,"90th_percentile":6693.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6589.57,"10th_percentile":6589.57,"90th_percentile":6619.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":17423.0,"10th_percentile":17423.0,"90th_percentile":17423.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":6498.63,"10th_percentile":6498.63,"90th_percentile":6498.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Neurostimulator and Related Procedures","code_information":[{"code":"5463","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":11574.43,"10th_percentile":11574.43,"90th_percentile":11574.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":12364.05,"10th_percentile":12364.05,"90th_percentile":12364.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Neurostimulator and Related Procedures","code_information":[{"code":"5464","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":23356.96,"10th_percentile":23356.96,"90th_percentile":23356.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":20152.2,"10th_percentile":20152.2,"90th_percentile":20152.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":19768.33,"10th_percentile":19765.17,"90th_percentile":21102.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Neurostimulator and Related Procedures","code_information":[{"code":"5465","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":32061.8,"10th_percentile":32061.8,"90th_percentile":32061.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":27704.03,"10th_percentile":27704.03,"90th_percentile":27704.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":31708.47,"10th_percentile":31708.47,"90th_percentile":31708.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":32060.32,"10th_percentile":30579.96,"90th_percentile":32234.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":31433.33,"10th_percentile":31433.33,"90th_percentile":31433.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Implantation of Drug Infusion Device","code_information":[{"code":"5471","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":18729.18,"10th_percentile":18729.18,"90th_percentile":18729.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":16870.73,"10th_percentile":16870.73,"90th_percentile":16870.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":17457.68,"10th_percentile":17457.68,"90th_percentile":17457.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":18728.2,"10th_percentile":17733.83,"90th_percentile":18750.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Extraocular, Repair, and Plastic Eye Procedures","code_information":[{"code":"5503","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":4327.1,"10th_percentile":4327.1,"90th_percentile":4327.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Imaging without Contrast","code_information":[{"code":"5521","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"129","median_amount":307.0,"10th_percentile":91.4,"90th_percentile":973.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"227","median_amount":91.12,"10th_percentile":88.35,"90th_percentile":177.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":438.0,"10th_percentile":438.0,"90th_percentile":438.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"529","median_amount":437.0,"10th_percentile":223.0,"90th_percentile":880.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"131","median_amount":88.98,"10th_percentile":86.97,"90th_percentile":199.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"398","median_amount":379.08,"10th_percentile":270.54,"90th_percentile":886.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1086.08,"10th_percentile":1086.08,"90th_percentile":1086.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":88.35,"10th_percentile":35.59,"90th_percentile":113.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"470","median_amount":90.76,"10th_percentile":88.71,"90th_percentile":179.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":35.59,"10th_percentile":35.59,"90th_percentile":125.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"16","median_amount":36.29,"10th_percentile":35.59,"90th_percentile":113.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"293","median_amount":194.81,"10th_percentile":194.81,"90th_percentile":689.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"280","median_amount":88.99,"10th_percentile":86.72,"90th_percentile":101.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Imaging without Contrast","code_information":[{"code":"5522","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"554","median_amount":854.5,"10th_percentile":268.0,"90th_percentile":1161.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1023","median_amount":109.59,"10th_percentile":106.69,"90th_percentile":224.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":726.0,"10th_percentile":571.8,"90th_percentile":1140.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"2396","median_amount":606.0,"10th_percentile":486.0,"90th_percentile":1150.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"600","median_amount":106.9,"10th_percentile":105.03,"90th_percentile":221.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1518","median_amount":697.68,"10th_percentile":333.18,"90th_percentile":1336.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":63.6,"10th_percentile":63.6,"90th_percentile":63.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"22","median_amount":69.84,"10th_percentile":67.45,"90th_percentile":113.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1849","median_amount":110.81,"10th_percentile":108.59,"90th_percentile":224.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":229.95,"10th_percentile":229.95,"90th_percentile":2310.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":112.97,"10th_percentile":112.97,"90th_percentile":112.97,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1071.0,"10th_percentile":1071.0,"90th_percentile":1071.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"29","median_amount":35.59,"10th_percentile":35.59,"90th_percentile":113.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":113.87,"10th_percentile":113.87,"90th_percentile":113.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"97","median_amount":46.84,"10th_percentile":35.59,"90th_percentile":113.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1261","median_amount":471.38,"10th_percentile":235.69,"90th_percentile":966.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1235","median_amount":108.64,"10th_percentile":105.61,"90th_percentile":220.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Imaging without Contrast","code_information":[{"code":"5523","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"106","median_amount":1533.0,"10th_percentile":252.9,"90th_percentile":2563.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"258","median_amount":248.85,"10th_percentile":242.53,"90th_percentile":351.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":901.0,"10th_percentile":901.0,"90th_percentile":901.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"517","median_amount":1238.0,"10th_percentile":601.0,"90th_percentile":1706.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"114","median_amount":243.97,"10th_percentile":238.75,"90th_percentile":538.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"247","median_amount":1067.0,"10th_percentile":410.86,"90th_percentile":1338.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":427.56,"10th_percentile":153.12,"90th_percentile":542.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"407","median_amount":252.84,"10th_percentile":247.48,"90th_percentile":462.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":252.9,"10th_percentile":252.9,"90th_percentile":252.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":153.12,"10th_percentile":105.28,"90th_percentile":157.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"15","median_amount":153.12,"10th_percentile":153.12,"90th_percentile":153.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"235","median_amount":525.31,"10th_percentile":299.0,"90th_percentile":1349.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"340","median_amount":247.95,"10th_percentile":242.63,"90th_percentile":536.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Imaging without Contrast","code_information":[{"code":"5524","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"20","median_amount":1161.45,"10th_percentile":660.0,"90th_percentile":2842.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"46","median_amount":567.6,"10th_percentile":550.15,"90th_percentile":575.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":1639.8,"10th_percentile":1639.8,"90th_percentile":1639.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"143","median_amount":1023.0,"10th_percentile":733.0,"90th_percentile":1586.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"27","median_amount":558.73,"10th_percentile":541.56,"90th_percentile":647.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"70","median_amount":713.73,"10th_percentile":604.05,"90th_percentile":1709.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"106","median_amount":569.29,"10th_percentile":550.15,"90th_percentile":660.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":299.12,"10th_percentile":299.12,"90th_percentile":299.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"68","median_amount":608.0,"10th_percentile":571.0,"90th_percentile":1240.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"56","median_amount":559.66,"10th_percentile":540.07,"90th_percentile":628.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Imaging with Contrast","code_information":[{"code":"5571","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"55","median_amount":1101.7,"10th_percentile":307.0,"90th_percentile":1718.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"136","median_amount":185.92,"10th_percentile":179.41,"90th_percentile":453.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":87.36,"10th_percentile":87.36,"90th_percentile":87.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"333","median_amount":1235.0,"10th_percentile":501.0,"90th_percentile":1726.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"81","median_amount":180.24,"10th_percentile":175.83,"90th_percentile":441.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"147","median_amount":785.0,"10th_percentile":277.0,"90th_percentile":996.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":1.19,"10th_percentile":1.19,"90th_percentile":1.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"299","median_amount":185.92,"10th_percentile":180.81,"90th_percentile":452.93,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":192.91,"10th_percentile":192.91,"90th_percentile":192.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":206.9,"10th_percentile":206.9,"90th_percentile":206.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"14","median_amount":75.04,"10th_percentile":35.59,"90th_percentile":206.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"112","median_amount":588.7,"10th_percentile":393.89,"90th_percentile":1233.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"179","median_amount":182.27,"10th_percentile":175.84,"90th_percentile":442.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Imaging with Contrast","code_information":[{"code":"5572","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"103","median_amount":1168.4,"10th_percentile":349.7,"90th_percentile":2372.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"228","median_amount":362.88,"10th_percentile":358.34,"90th_percentile":478.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"748","median_amount":1238.0,"10th_percentile":854.17,"90th_percentile":1813.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"176","median_amount":356.73,"10th_percentile":352.74,"90th_percentile":457.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"384","median_amount":1067.0,"10th_percentile":719.37,"90th_percentile":1338.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":254.63,"10th_percentile":254.63,"90th_percentile":254.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"527","median_amount":367.38,"10th_percentile":361.34,"90th_percentile":472.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":368.38,"10th_percentile":368.38,"90th_percentile":368.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":254.63,"10th_percentile":254.63,"90th_percentile":254.63,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":254.63,"10th_percentile":254.63,"90th_percentile":431.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"274","median_amount":824.45,"10th_percentile":712.0,"90th_percentile":1648.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"341","median_amount":358.48,"10th_percentile":354.12,"90th_percentile":466.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Imaging with Contrast","code_information":[{"code":"5573","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":3387.86,"10th_percentile":3387.86,"90th_percentile":4036.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1156.87,"10th_percentile":1156.87,"90th_percentile":1183.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":2480.4,"10th_percentile":2480.4,"90th_percentile":3855.43,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1164.02,"10th_percentile":1164.02,"90th_percentile":1164.02,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":2205.0,"10th_percentile":1696.0,"90th_percentile":5440.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":490.19,"10th_percentile":490.19,"90th_percentile":490.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1157.52,"10th_percentile":1129.74,"90th_percentile":1240.88,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Nuclear Medicine and Related Services","code_information":[{"code":"5591","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":1242.18,"10th_percentile":1242.18,"90th_percentile":2088.22,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"21","median_amount":416.96,"10th_percentile":404.19,"90th_percentile":422.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"48","median_amount":1554.0,"10th_percentile":1313.0,"90th_percentile":2160.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":408.78,"10th_percentile":396.9,"90th_percentile":1535.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"29","median_amount":1194.0,"10th_percentile":1104.0,"90th_percentile":1447.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"29","median_amount":421.77,"10th_percentile":408.19,"90th_percentile":534.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"1 through 10","median_amount":1273.8,"10th_percentile":1273.8,"90th_percentile":1273.8},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":237.03,"10th_percentile":237.03,"90th_percentile":237.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"17","median_amount":884.18,"10th_percentile":884.18,"90th_percentile":935.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"20","median_amount":411.73,"10th_percentile":400.29,"90th_percentile":828.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Nuclear Medicine and Related Services","code_information":[{"code":"5592","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"11","median_amount":1551.11,"10th_percentile":1040.0,"90th_percentile":2549.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"17","median_amount":566.31,"10th_percentile":544.09,"90th_percentile":1357.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"51","median_amount":1475.21,"10th_percentile":1313.0,"90th_percentile":1587.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":531.66,"10th_percentile":531.66,"90th_percentile":564.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"24","median_amount":1633.5,"10th_percentile":1368.55,"90th_percentile":1964.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":685.65,"10th_percentile":685.65,"90th_percentile":685.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"25","median_amount":566.3,"10th_percentile":540.09,"90th_percentile":787.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":302.29,"10th_percentile":302.29,"90th_percentile":302.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"14","median_amount":1158.73,"10th_percentile":1158.73,"90th_percentile":1353.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"19","median_amount":558.15,"10th_percentile":534.5,"90th_percentile":1468.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Nuclear Medicine and Related Services","code_information":[{"code":"5593","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":1309.89,"10th_percentile":1309.89,"90th_percentile":2532.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":1554.0,"10th_percentile":1313.0,"90th_percentile":2160.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1962.3,"10th_percentile":1962.3,"90th_percentile":1962.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":1447.0,"10th_percentile":1447.0,"90th_percentile":1447.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1351.31,"10th_percentile":1314.89,"90th_percentile":2245.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":108.44,"10th_percentile":108.44,"90th_percentile":108.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":3044.09,"10th_percentile":3044.09,"90th_percentile":3044.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1284.71,"10th_percentile":1284.71,"90th_percentile":1284.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Nuclear Medicine and Related Services","code_information":[{"code":"5594","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"24","median_amount":5212.76,"10th_percentile":1485.36,"90th_percentile":9844.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"72","median_amount":1485.36,"10th_percentile":1463.51,"90th_percentile":1493.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"200","median_amount":1970.0,"10th_percentile":1540.0,"90th_percentile":3583.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"66","median_amount":1466.04,"10th_percentile":1444.54,"90th_percentile":3816.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"93","median_amount":3220.1,"10th_percentile":3220.1,"90th_percentile":3862.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"254","median_amount":1491.36,"10th_percentile":1465.62,"90th_percentile":3883.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2764.57,"10th_percentile":2764.57,"90th_percentile":2764.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":904.77,"10th_percentile":904.77,"90th_percentile":904.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":904.77,"10th_percentile":904.77,"90th_percentile":904.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"42","median_amount":3356.21,"10th_percentile":3356.21,"90th_percentile":7160.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"119","median_amount":1460.1,"10th_percentile":1435.02,"90th_percentile":3806.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Therapeutic Radiation Treatment Preparation","code_information":[{"code":"5611","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":2866.0,"10th_percentile":2371.0,"90th_percentile":5053.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":241.78,"10th_percentile":241.78,"90th_percentile":1907.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"15","median_amount":246.61,"10th_percentile":246.61,"90th_percentile":1699.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"22","median_amount":241.23,"10th_percentile":137.45,"90th_percentile":241.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Therapeutic Radiation Treatment Preparation","code_information":[{"code":"5612","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"15","median_amount":2448.0,"10th_percentile":1166.0,"90th_percentile":12826.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":730.84,"10th_percentile":367.3,"90th_percentile":778.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"58","median_amount":4730.0,"10th_percentile":3639.0,"90th_percentile":5053.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"24","median_amount":769.5,"10th_percentile":382.86,"90th_percentile":3322.29,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"21","median_amount":2604.0,"10th_percentile":1257.0,"90th_percentile":2604.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"55","median_amount":781.06,"10th_percentile":388.94,"90th_percentile":4627.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"22","median_amount":3670.0,"10th_percentile":3571.0,"90th_percentile":3803.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"41","median_amount":736.6,"10th_percentile":381.32,"90th_percentile":3482.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Therapeutic Radiation Treatment Preparation","code_information":[{"code":"5613","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"12","median_amount":5483.0,"10th_percentile":4130.0,"90th_percentile":9110.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"19","median_amount":2139.83,"10th_percentile":1104.52,"90th_percentile":2539.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"42","median_amount":5053.0,"10th_percentile":4321.0,"90th_percentile":5053.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":2210.52,"10th_percentile":2106.44,"90th_percentile":3050.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"20","median_amount":2604.0,"10th_percentile":1197.0,"90th_percentile":3467.86,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":843.44,"10th_percentile":843.44,"90th_percentile":843.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"41","median_amount":2385.19,"10th_percentile":2114.55,"90th_percentile":3101.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":843.44,"10th_percentile":843.44,"90th_percentile":843.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":3803.0,"10th_percentile":3571.0,"90th_percentile":3803.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"27","median_amount":2482.64,"10th_percentile":2071.98,"90th_percentile":3159.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Radiation Therapy","code_information":[{"code":"5621","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"15","median_amount":922.0,"10th_percentile":922.0,"90th_percentile":922.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"22","median_amount":104.33,"10th_percentile":104.33,"90th_percentile":104.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"35","median_amount":106.42,"10th_percentile":106.42,"90th_percentile":106.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"71","median_amount":104.34,"10th_percentile":104.13,"90th_percentile":104.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Radiation Therapy","code_information":[{"code":"5622","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"57","median_amount":1224.0,"10th_percentile":1156.0,"90th_percentile":2448.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"121","median_amount":402.28,"10th_percentile":263.86,"90th_percentile":540.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"482","median_amount":4000.0,"10th_percentile":1156.0,"90th_percentile":5053.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"275","median_amount":394.39,"10th_percentile":259.75,"90th_percentile":531.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"198","median_amount":1257.0,"10th_percentile":426.56,"90th_percentile":2604.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"499","median_amount":402.28,"10th_percentile":263.86,"90th_percentile":542.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"96","median_amount":3571.0,"10th_percentile":1156.0,"90th_percentile":3803.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"191","median_amount":393.29,"10th_percentile":258.7,"90th_percentile":531.28,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Radiation Therapy","code_information":[{"code":"5623","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"196","median_amount":1166.0,"10th_percentile":1020.0,"90th_percentile":2332.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"126","median_amount":580.92,"10th_percentile":404.26,"90th_percentile":1161.16,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"300","median_amount":4321.0,"10th_percentile":4088.0,"90th_percentile":5053.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"158","median_amount":571.37,"10th_percentile":564.99,"90th_percentile":1090.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"177","median_amount":2604.0,"10th_percentile":1197.0,"90th_percentile":2915.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"16","median_amount":295.58,"10th_percentile":295.58,"90th_percentile":370.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"216","median_amount":582.79,"10th_percentile":573.95,"90th_percentile":716.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"23","median_amount":295.58,"10th_percentile":295.58,"90th_percentile":370.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"78","median_amount":3803.0,"10th_percentile":3571.0,"90th_percentile":3803.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"119","median_amount":565.0,"10th_percentile":562.7,"90th_percentile":701.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Radiation Therapy","code_information":[{"code":"5624","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":3901.55,"10th_percentile":2735.55,"90th_percentile":4027.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1481.25,"10th_percentile":1063.85,"90th_percentile":1873.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":2604.0,"10th_percentile":2604.0,"90th_percentile":3491.76,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1868.07,"10th_percentile":1856.94,"90th_percentile":2008.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1820.55,"10th_percentile":1820.55,"90th_percentile":1957.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 6 Radiation Therapy","code_information":[{"code":"5626","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":1224.0,"10th_percentile":1224.0,"90th_percentile":2448.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"17","median_amount":1761.84,"10th_percentile":80.0,"90th_percentile":1895.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"48","median_amount":4321.0,"10th_percentile":4321.0,"90th_percentile":5053.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":1828.35,"10th_percentile":1828.35,"90th_percentile":1975.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":6929.08,"10th_percentile":2604.0,"90th_percentile":13519.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"52","median_amount":1864.92,"10th_percentile":1761.84,"90th_percentile":2005.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":703.0,"10th_percentile":678.0,"90th_percentile":4506.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"22","median_amount":1828.36,"10th_percentile":1821.76,"90th_percentile":1958.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 7 Radiation Therapy","code_information":[{"code":"5627","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":5053.0,"10th_percentile":5053.0,"90th_percentile":5053.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":7790.28,"10th_percentile":7790.28,"90th_percentile":9125.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. 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Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Therapeutic Nuclear Medicine","code_information":[{"code":"5661","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. 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The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":2044.03,"10th_percentile":2044.03,"90th_percentile":2044.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":915.99,"10th_percentile":915.99,"90th_percentile":915.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Pathology","code_information":[{"code":"5671","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":167.0,"10th_percentile":167.0,"90th_percentile":501.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"28","median_amount":54.13,"10th_percentile":53.61,"90th_percentile":55.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"52","median_amount":249.0,"10th_percentile":223.0,"90th_percentile":419.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"13","median_amount":53.28,"10th_percentile":52.77,"90th_percentile":53.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"32","median_amount":233.28,"10th_percentile":134.46,"90th_percentile":466.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"48","median_amount":54.13,"10th_percentile":53.61,"90th_percentile":54.13,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"28","median_amount":30.98,"10th_percentile":30.98,"90th_percentile":78.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"27","median_amount":53.07,"10th_percentile":52.56,"90th_percentile":53.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Pathology","code_information":[{"code":"5672","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":548.0,"10th_percentile":548.0,"90th_percentile":668.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"19","median_amount":173.29,"10th_percentile":171.94,"90th_percentile":4300.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"23","median_amount":267.0,"10th_percentile":223.0,"90th_percentile":1189.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":169.26,"10th_percentile":169.26,"90th_percentile":174.21,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"14","median_amount":566.0,"10th_percentile":504.36,"90th_percentile":707.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"61","median_amount":171.94,"10th_percentile":42.6,"90th_percentile":177.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":27.5,"10th_percentile":27.5,"90th_percentile":27.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"14","median_amount":257.24,"10th_percentile":166.14,"90th_percentile":466.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":173.5,"10th_percentile":173.5,"90th_percentile":173.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Pathology","code_information":[{"code":"5673","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":1433.0,"10th_percentile":1433.0,"90th_percentile":1433.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":520.33,"10th_percentile":520.33,"90th_percentile":520.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":267.0,"10th_percentile":267.0,"90th_percentile":5698.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":355.3,"10th_percentile":74.51,"90th_percentile":370.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":523.5,"10th_percentile":523.5,"90th_percentile":1570.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"20","median_amount":372.34,"10th_percentile":312.72,"90th_percentile":10527.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":394.24,"10th_percentile":394.24,"90th_percentile":394.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":630.15,"10th_percentile":317.87,"90th_percentile":1045.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"15","median_amount":365.05,"10th_percentile":353.86,"90th_percentile":720.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Pathology","code_information":[{"code":"5674","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":6465.8,"10th_percentile":6465.8,"90th_percentile":6465.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Drug Administration","code_information":[{"code":"5691","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":2645.53,"10th_percentile":2645.53,"90th_percentile":4235.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2535.15,"10th_percentile":1886.5,"90th_percentile":8232.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":2354.66,"10th_percentile":2354.66,"90th_percentile":6132.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1404.45,"10th_percentile":1404.45,"90th_percentile":2527.71,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":3707.0,"10th_percentile":2036.0,"90th_percentile":9015.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"11","median_amount":2051.99,"10th_percentile":600.0,"90th_percentile":3858.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":782.07,"10th_percentile":782.07,"90th_percentile":782.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":425.35,"10th_percentile":321.16,"90th_percentile":822.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":1582.0,"10th_percentile":1582.0,"90th_percentile":2324.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"21","median_amount":2519.43,"10th_percentile":1852.65,"90th_percentile":4231.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Drug Administration","code_information":[{"code":"5692","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"29","median_amount":3633.45,"10th_percentile":986.96,"90th_percentile":5576.15,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"55","median_amount":1602.73,"10th_percentile":72.31,"90th_percentile":10069.47,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"142","median_amount":2816.64,"10th_percentile":794.5,"90th_percentile":11332.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"29","median_amount":1804.9,"10th_percentile":400.38,"90th_percentile":5285.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"61","median_amount":2812.6,"10th_percentile":167.29,"90th_percentile":16465.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":32.32,"10th_percentile":32.32,"90th_percentile":32.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"79","median_amount":1848.15,"10th_percentile":227.0,"90th_percentile":9976.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":32.32,"10th_percentile":32.32,"90th_percentile":32.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":32.32,"10th_percentile":32.32,"90th_percentile":32.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"35","median_amount":3747.6,"10th_percentile":449.0,"90th_percentile":9369.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"91","median_amount":382.35,"10th_percentile":73.63,"90th_percentile":9780.98,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Drug Administration","code_information":[{"code":"5693","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"40","median_amount":1463.08,"10th_percentile":225.46,"90th_percentile":4983.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"62","median_amount":222.03,"10th_percentile":211.41,"90th_percentile":4356.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"304","median_amount":999.47,"10th_percentile":291.2,"90th_percentile":4326.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"52","median_amount":299.25,"10th_percentile":217.5,"90th_percentile":3111.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"192","median_amount":615.51,"10th_percentile":245.86,"90th_percentile":3317.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":134.06,"10th_percentile":134.06,"90th_percentile":295.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"154","median_amount":221.85,"10th_percentile":212.27,"90th_percentile":2218.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":93.44,"10th_percentile":93.44,"90th_percentile":93.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":32.32,"10th_percentile":32.32,"90th_percentile":243.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"153","median_amount":449.0,"10th_percentile":422.0,"90th_percentile":2509.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"124","median_amount":335.97,"10th_percentile":211.49,"90th_percentile":3727.78,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Drug Administration","code_information":[{"code":"5694","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"58","median_amount":4222.43,"10th_percentile":717.82,"90th_percentile":31214.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"130","median_amount":7781.51,"10th_percentile":395.62,"90th_percentile":16045.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"583","median_amount":2321.86,"10th_percentile":750.69,"90th_percentile":22850.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"116","median_amount":2426.92,"10th_percentile":385.61,"90th_percentile":13295.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"242","median_amount":4856.46,"10th_percentile":1256.22,"90th_percentile":21076.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"304","median_amount":2464.84,"10th_percentile":97.68,"90th_percentile":18080.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":336.82,"10th_percentile":336.82,"90th_percentile":336.82,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"174","median_amount":4132.04,"10th_percentile":1355.0,"90th_percentile":15638.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"249","median_amount":8124.82,"10th_percentile":420.24,"90th_percentile":13334.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Diagnostic Tests and Related Services","code_information":[{"code":"5721","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":506.0,"10th_percentile":506.0,"90th_percentile":680.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":158.49,"10th_percentile":158.49,"90th_percentile":158.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"21","median_amount":473.0,"10th_percentile":473.0,"90th_percentile":648.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":154.54,"10th_percentile":154.54,"90th_percentile":371.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"19","median_amount":680.0,"10th_percentile":566.0,"90th_percentile":680.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":156.99,"10th_percentile":156.99,"90th_percentile":157.99,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":298.0,"10th_percentile":298.0,"90th_percentile":680.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":154.71,"10th_percentile":154.21,"90th_percentile":154.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Diagnostic Tests and Related Services","code_information":[{"code":"5722","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"26","median_amount":531.0,"10th_percentile":226.29,"90th_percentile":929.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":226.37,"10th_percentile":225.39,"90th_percentile":312.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"91","median_amount":544.0,"10th_percentile":223.0,"90th_percentile":680.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":307.58,"10th_percentile":220.79,"90th_percentile":394.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"58","median_amount":680.0,"10th_percentile":513.13,"90th_percentile":680.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"45","median_amount":312.45,"10th_percentile":224.29,"90th_percentile":402.6,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"47","median_amount":317.0,"10th_percentile":307.0,"90th_percentile":592.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"39","median_amount":306.33,"10th_percentile":220.1,"90th_percentile":307.33,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Diagnostic Tests and Related Services","code_information":[{"code":"5723","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"14","median_amount":938.04,"10th_percentile":387.62,"90th_percentile":2580.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"26","median_amount":389.52,"10th_percentile":387.62,"90th_percentile":616.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"64","median_amount":437.0,"10th_percentile":223.0,"90th_percentile":1128.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"18","median_amount":381.57,"10th_percentile":225.0,"90th_percentile":831.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"33","median_amount":569.37,"10th_percentile":475.28,"90th_percentile":1439.62,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":144.59,"10th_percentile":144.59,"90th_percentile":144.59,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"69","median_amount":388.62,"10th_percentile":387.62,"90th_percentile":573.54,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1897.0,"10th_percentile":1897.0,"90th_percentile":1897.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"35","median_amount":475.0,"10th_percentile":457.0,"90th_percentile":1281.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"52","median_amount":381.02,"10th_percentile":380.22,"90th_percentile":488.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Diagnostic Tests and Related Services","code_information":[{"code":"5724","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"17","median_amount":2008.0,"10th_percentile":1022.83,"90th_percentile":2108.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"20","median_amount":898.41,"10th_percentile":892.02,"90th_percentile":1028.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"83","median_amount":648.0,"10th_percentile":473.0,"90th_percentile":1180.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"14","median_amount":882.41,"10th_percentile":878.09,"90th_percentile":1004.9,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"16","median_amount":2314.0,"10th_percentile":1883.0,"90th_percentile":2314.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":477.75,"10th_percentile":477.75,"90th_percentile":477.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"42","median_amount":895.66,"10th_percentile":892.02,"90th_percentile":1023.83,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":477.75,"10th_percentile":477.75,"90th_percentile":477.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"32","median_amount":1304.0,"10th_percentile":1224.0,"90th_percentile":1304.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"29","median_amount":875.53,"10th_percentile":874.83,"90th_percentile":1286.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 1 Minor Procedures","code_information":[{"code":"5731","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"27","median_amount":121.0,"10th_percentile":30.04,"90th_percentile":121.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"67","median_amount":30.04,"10th_percentile":24.57,"90th_percentile":30.68,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"161","median_amount":121.0,"10th_percentile":98.0,"90th_percentile":223.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"39","median_amount":29.57,"10th_percentile":24.19,"90th_percentile":29.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"74","median_amount":65.34,"10th_percentile":55.18,"90th_percentile":213.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"166","median_amount":30.05,"10th_percentile":24.57,"90th_percentile":30.66,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"46","median_amount":17.02,"10th_percentile":17.02,"90th_percentile":98.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"85","median_amount":29.46,"10th_percentile":24.09,"90th_percentile":30.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 2 Minor Procedures","code_information":[{"code":"5732","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":167.0,"10th_percentile":167.0,"90th_percentile":167.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":196.95,"10th_percentile":196.95,"90th_percentile":354.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":648.0,"10th_percentile":648.0,"90th_percentile":648.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":38.19,"10th_percentile":38.19,"90th_percentile":38.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":622.14,"10th_percentile":167.94,"90th_percentile":850.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":234.6,"10th_percentile":38.96,"90th_percentile":1124.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":1124.0,"10th_percentile":562.0,"90th_percentile":1686.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":38.04,"10th_percentile":38.04,"90th_percentile":154.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 3 Minor Procedures","code_information":[{"code":"5733","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"15","median_amount":656.0,"10th_percentile":72.98,"90th_percentile":1129.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"41","median_amount":61.28,"10th_percentile":59.59,"90th_percentile":245.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"100","median_amount":267.0,"10th_percentile":1.8,"90th_percentile":649.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"24","median_amount":121.22,"10th_percentile":58.67,"90th_percentile":422.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"34","median_amount":566.0,"10th_percentile":233.7,"90th_percentile":734.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"71","median_amount":61.53,"10th_percentile":59.84,"90th_percentile":308.4,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":62.53,"10th_percentile":62.53,"90th_percentile":62.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":16.87,"10th_percentile":16.87,"90th_percentile":68.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":16.87,"10th_percentile":16.87,"90th_percentile":16.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"21","median_amount":536.0,"10th_percentile":27.99,"90th_percentile":699.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"39","median_amount":71.56,"10th_percentile":58.43,"90th_percentile":350.58,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 4 Minor Procedures","code_information":[{"code":"5734","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"22","median_amount":622.0,"10th_percentile":139.41,"90th_percentile":1048.52,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"87","median_amount":138.21,"10th_percentile":129.34,"90th_percentile":140.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"186","median_amount":267.0,"10th_percentile":223.0,"90th_percentile":1425.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"34","median_amount":136.05,"10th_percentile":127.32,"90th_percentile":136.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"110","median_amount":566.0,"10th_percentile":283.63,"90th_percentile":707.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":40.87,"10th_percentile":40.87,"90th_percentile":40.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"207","median_amount":138.2,"10th_percentile":129.34,"90th_percentile":139.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":138.76,"10th_percentile":138.75,"90th_percentile":139.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":34.0,"10th_percentile":34.0,"90th_percentile":48.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":52.8,"10th_percentile":52.8,"90th_percentile":52.8,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"57","median_amount":30.66,"10th_percentile":14.74,"90th_percentile":126.81,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"108","median_amount":135.49,"10th_percentile":126.81,"90th_percentile":135.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Level 5 Minor Procedures","code_information":[{"code":"5735","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":109.0,"10th_percentile":109.0,"90th_percentile":109.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Rehabilitation","code_information":[{"code":"5771","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"24","median_amount":1367.1,"10th_percentile":133.91,"90th_percentile":4101.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"50","median_amount":672.8,"10th_percentile":134.56,"90th_percentile":1473.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"105","median_amount":648.0,"10th_percentile":473.0,"90th_percentile":1128.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"32","median_amount":746.22,"10th_percentile":248.74,"90th_percentile":1243.7,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"44","median_amount":851.52,"10th_percentile":240.22,"90th_percentile":2882.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"123","median_amount":807.0,"10th_percentile":254.08,"90th_percentile":1479.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"26","median_amount":990.0,"10th_percentile":351.0,"90th_percentile":3510.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"114","median_amount":870.59,"10th_percentile":131.28,"90th_percentile":1575.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Resuscitation and Cardioversion","code_information":[{"code":"5781","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":1916.93,"10th_percentile":1257.61,"90th_percentile":3659.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":1208.74,"10th_percentile":686.56,"90th_percentile":1262.06,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"25","median_amount":1028.5,"10th_percentile":737.32,"90th_percentile":6666.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1187.9,"10th_percentile":1187.9,"90th_percentile":1234.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":2501.52,"10th_percentile":1198.25,"90th_percentile":3343.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"27","median_amount":1210.36,"10th_percentile":688.56,"90th_percentile":2376.72,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1398.57,"10th_percentile":1398.57,"90th_percentile":1398.57,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":1882.0,"10th_percentile":1311.0,"90th_percentile":2749.87,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"22","median_amount":1229.56,"10th_percentile":673.5,"90th_percentile":1241.56,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Pulmonary Treatment","code_information":[{"code":"5791","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":223.91,"10th_percentile":223.91,"90th_percentile":223.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":235.32,"10th_percentile":235.32,"90th_percentile":235.32,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":223.0,"10th_percentile":223.0,"90th_percentile":223.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ventilation Initiation and Management","code_information":[{"code":"5801","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":350.0,"10th_percentile":350.0,"90th_percentile":350.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1119.75,"10th_percentile":1119.75,"90th_percentile":1119.75,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":429.0,"10th_percentile":429.0,"90th_percentile":429.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Instill, bupivac and meloxic","code_information":[{"code":"9440","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":2135.0,"10th_percentile":2135.0,"90th_percentile":2135.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Platelet pheres leukoreduced","code_information":[{"code":"9501","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":3347.0,"10th_percentile":3347.0,"90th_percentile":3347.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1476.01,"10th_percentile":1476.01,"90th_percentile":1476.01,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Platelet pheresis irradiated","code_information":[{"code":"9502","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1613.49,"10th_percentile":1613.49,"90th_percentile":1613.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"RBC leukocytes reduced","code_information":[{"code":"9512","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":353.87,"10th_percentile":353.87,"90th_percentile":535.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"RBC leukoreduced irradiated","code_information":[{"code":"9522","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":950.05,"10th_percentile":950.05,"90th_percentile":950.05,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":1906.04,"10th_percentile":1906.04,"90th_percentile":1906.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":684.55,"10th_percentile":684.55,"90th_percentile":684.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"28","median_amount":1161.46,"10th_percentile":683.33,"90th_percentile":1770.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":966.95,"10th_percentile":966.95,"90th_percentile":966.95,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Plate pheres leukoredu irrad","code_information":[{"code":"9530","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":1789.44,"10th_percentile":1789.44,"90th_percentile":2256.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":553.02,"10th_percentile":553.02,"90th_percentile":992.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"RBC, l/r, cmv-neg, irrad","code_information":[{"code":"9533","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":1948.0,"10th_percentile":1948.0,"90th_percentile":1948.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Platelets pheresis path redu","code_information":[{"code":"9536","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2418.31,"10th_percentile":2418.31,"90th_percentile":3361.09,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":2382.38,"10th_percentile":2382.38,"90th_percentile":2382.38,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":2199.41,"10th_percentile":1933.66,"90th_percentile":4237.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"12","median_amount":1666.69,"10th_percentile":1025.71,"90th_percentile":1829.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":343.0,"10th_percentile":343.0,"90th_percentile":343.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Clinical Diagnostic Lab Services","code_information":[{"code":"N800","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"223","median_amount":334.0,"10th_percentile":50.01,"90th_percentile":1440.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"839","median_amount":41.51,"10th_percentile":8.23,"90th_percentile":124.34,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1744","median_amount":267.0,"10th_percentile":192.0,"90th_percentile":411.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"587","median_amount":42.48,"10th_percentile":11.06,"90th_percentile":133.12,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"711","median_amount":458.74,"10th_percentile":103.68,"90th_percentile":707.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"15","median_amount":12.65,"10th_percentile":5.63,"90th_percentile":45.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1105","median_amount":35.06,"10th_percentile":9.53,"90th_percentile":116.73,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"16","median_amount":49.5,"10th_percentile":15.5,"90th_percentile":73.25,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"25","median_amount":13.38,"10th_percentile":4.55,"90th_percentile":57.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1147","median_amount":33.75,"10th_percentile":7.87,"90th_percentile":127.67,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"963","median_amount":42.33,"10th_percentile":12.64,"90th_percentile":129.04,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Therapy Services","code_information":[{"code":"N801","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"481","median_amount":600.0,"10th_percentile":109.52,"90th_percentile":720.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1335","median_amount":90.28,"10th_percentile":74.62,"90th_percentile":116.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"2085","median_amount":592.0,"10th_percentile":422.0,"90th_percentile":800.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"673","median_amount":96.08,"10th_percentile":72.47,"90th_percentile":165.17,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1054","median_amount":213.0,"10th_percentile":170.0,"90th_percentile":295.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":213.0,"10th_percentile":213.0,"90th_percentile":213.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"48","median_amount":178.89,"10th_percentile":40.98,"90th_percentile":565.92,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1593","median_amount":92.7,"10th_percentile":74.31,"90th_percentile":147.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":144.15,"10th_percentile":144.15,"90th_percentile":187.91,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"138","median_amount":210.71,"10th_percentile":74.09,"90th_percentile":1131.84,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1328","median_amount":215.0,"10th_percentile":202.0,"90th_percentile":216.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":117.1,"10th_percentile":90.4,"90th_percentile":117.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1532","median_amount":92.72,"10th_percentile":72.47,"90th_percentile":140.51,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."}]}]},{"description":"Mammography Services","code_information":[{"code":"N804","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"179","median_amount":394.0,"10th_percentile":355.0,"90th_percentile":445.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"235","median_amount":116.27,"10th_percentile":112.86,"90th_percentile":116.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"1 through 10","median_amount":267.0,"10th_percentile":267.0,"90th_percentile":267.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"861","median_amount":290.0,"10th_percentile":223.0,"90th_percentile":437.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"135","median_amount":114.46,"10th_percentile":111.11,"90th_percentile":114.46,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"478","median_amount":445.0,"10th_percentile":377.0,"90th_percentile":445.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":44.03,"10th_percentile":22.02,"90th_percentile":116.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"598","median_amount":116.27,"10th_percentile":112.86,"90th_percentile":116.27,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":123.11,"10th_percentile":123.11,"90th_percentile":123.11,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":311.5,"10th_percentile":311.5,"90th_percentile":311.5,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":44.03,"10th_percentile":44.03,"90th_percentile":44.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":44.03,"10th_percentile":44.03,"90th_percentile":44.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"470","median_amount":257.14,"10th_percentile":257.14,"90th_percentile":257.14,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"282","median_amount":114.0,"10th_percentile":110.66,"90th_percentile":114.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Observation, Other","code_information":[{"code":"N811","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":2532.0,"10th_percentile":2532.0,"90th_percentile":2532.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"1 through 10","median_amount":92.62,"10th_percentile":92.62,"90th_percentile":817.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":633.31,"10th_percentile":633.31,"90th_percentile":633.31,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Non-covered Services","code_information":[{"code":"N900","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"22","median_amount":614.0,"10th_percentile":268.0,"90th_percentile":650.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"32","median_amount":87.52,"10th_percentile":81.66,"90th_percentile":112.48,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"127","median_amount":290.0,"10th_percentile":223.0,"90th_percentile":437.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"19","median_amount":86.16,"10th_percentile":84.03,"90th_percentile":971.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"75","median_amount":412.6,"10th_percentile":213.0,"90th_percentile":463.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":44.03,"10th_percentile":44.03,"90th_percentile":44.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"78","median_amount":87.82,"10th_percentile":87.52,"90th_percentile":259.79,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":44.03,"10th_percentile":44.03,"90th_percentile":44.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"68","median_amount":386.06,"10th_percentile":386.06,"90th_percentile":495.1,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"49","median_amount":85.81,"10th_percentile":83.7,"90th_percentile":111.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Packaged Services","code_information":[{"code":"N902","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"1 through 10","median_amount":11.42,"10th_percentile":11.33,"90th_percentile":521.39,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"15","median_amount":67.2,"10th_percentile":57.6,"90th_percentile":1047.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"1 through 10","median_amount":58.52,"10th_percentile":58.52,"90th_percentile":105.2,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"1 through 10","median_amount":0.03,"10th_percentile":0.03,"90th_percentile":0.03,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"1 through 10","median_amount":2.74,"10th_percentile":2.74,"90th_percentile":2.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"1 through 10","median_amount":5.3,"10th_percentile":5.3,"90th_percentile":5.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Not Recognized by OPPS","code_information":[{"code":"N905","type":"APC"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surgery-Single ($): 4824] [Ablation ($): 32525] [Cardiac Cath ($): 10912] [Observation ($): 4057] [ED Level 1--99281 ($): 909] [ED Level 2--99282 ($): 909] [ED Level 3--99283 ($): 1399] [ED Level 4--99284 ($): 1399] [ED Level 5--99285 ($): 1399] [Critical Care ($): 1328] [Other Cardiac Testing (%BC): 66.9 Maximum Reimbursement 4148] [Sleep Studies ($): 2108] [Sleep Studies-Unattended ($): 531] [Chemotherapy ($): 1469] [Nuclear Medicine ($): 1092] [Radiation Therapy ($): 1224] [CT Scan OP ($): 1119] [MRI OP ($): 1652] [Positron Emission Tomography ($): 4994] [Radiology ($): 322] [Laboratory ($): 175] [Occupational Therapy ($): 189] [Physical Therapy ($): 189] [Speech Therapy ($): 189] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant ($): 0 Charge Threshold 1082 (%BC): 35] [Hyperbarics ($): 594] [All Other OP (%BC): 66.9 Maximum Reimbursement 6155]","count":"43","median_amount":1625.84,"10th_percentile":54.38,"90th_percentile":1724.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[OP Surgery  (%BC): 60 Maximum Reimbursement 4602] [Observation (%BC): 60 Maximum Reimbursement 2157] [Emergency Department (%BC): 60 Maximum Reimbursement 755] [Sleep Studies ($): 2033] [Oncology (%BC): 60] [Radiation Therapy  (%BC): 60] [CT OP Scan (%BC): 60] [Positron Emission Tomography ($): 4188] [Occupational Therapy (%BC): 60] [Physical Therapy (%BC): 60] [Speech Therapy (%BC): 60] [OP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [Other Outpatient Implant ($): 0 Charge Threshold 500 (%BC): 60] [All Other OP (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 1220] [Cardiac Cath ($): 10211] [Lithotripsy ($): 6299] [PTCA ($): 20538] [Observation ($): 3252] [ED Level 1--99281 ($): 325] [ED Level 2--99282 ($): 1218] [ED Level 3--99283 ($): 1218] [ED Level 4--99284 ($): 1557] [ED Level 5--99285 ($): 1557] [Electrophysiology and Mapping Studies ($): 20538] [Other Cardiac Testing ($): 847] [EEG ($): 527] [Chemotherapy ($): 816] [Nuclear Medicine ($): 1517] [Radiation Therapy ($): 4991] [CT Scan OP ($): 1194] [MRI OP ($): 1429] [Positron Emission Tomography ($): 1939] [Laboratory ($): 257] [Occupational Therapy ($): 488] [Physical Therapy ($): 488] [Speech Therapy ($): 488] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 21] [IV Therapy ($): 816]","count":"190","median_amount":1496.0,"10th_percentile":189.32,"90th_percentile":1933.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 79 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 4558] [Cardiac Cath ($): 10791] [Observation ($): 2997] [ED Level 1--99281 ($): 1360] [ED Level 2--99282 ($): 1360] [ED Level 3--99283 ($): 1950] [ED Level 4--99284 ($): 1987] [ED Level 5--99285 ($): 1987] [Critical Care ($): 2014] [Sleep Studies-Unattended ($): 741] [Chemotherapy ($): 3476] [Nuclear Medicine ($): 1481] [Radiation Therapy ($): 2758] [CT Scan OP ($): 1019] [MRI OP ($): 1371] [Mammography-Diagnostic ($): 472] [Mammography-Screening ($): 472] [Positron Emission Tomography ($): 3952] [Radiology (%BC): 55.3 Maximum Reimbursement 990] [Laboratory (%BC): 55.3 Maximum Reimbursement 723] [Hemodialysis ($): 5194] [Peritoneal Dialysis, CAPD, and CCPD ($): 5194] [Occupational Therapy ($): 222] [Physical Therapy ($): 222] [Resp. Services/Therapy ($): 222] [Speech Therapy ($): 222] [OP High Cost Drugs Fee Schedule: FEE SCHEDULE] [Other Outpatient Implant (%BC): 22.4] [Hyperbarics ($): 2294] [All Other OP (%BC): 45.7 Maximum Reimbursement 6404]","count":"107","median_amount":1338.0,"10th_percentile":566.0,"90th_percentile":1338.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [OP Surg. Group 0 ($): FEE SCHEDULE] [OP Surg. Group 1 ($): FEE SCHEDULE] [OP Surg. Group 2 ($): FEE SCHEDULE] [OP Surg. Group 3 ($): FEE SCHEDULE] [OP Surg. Group 4 ($): FEE SCHEDULE] [OP Surg. Group 5 ($): FEE SCHEDULE] [OP Surg. Group 6 ($): FEE SCHEDULE] [OP Surg. Group 7 ($): FEE SCHEDULE] [OP Surg. Group 8 ($): FEE SCHEDULE] [OP Surg. Group 9 ($): FEE SCHEDULE] [OP Surg. Group 10 ($): FEE SCHEDULE] [OP Surg. Ungroupable ($): 3214] [Insertion of Automatic Implantable Cardiac Defibrillator (AICD) ($): 4357] [Insertion of Permanent Pacemaker ($): 6323] [PTCA w/ Drug Eluting Stent ($): 13829] [PTCA w/non Drug Eluting Stent ($): 13829] [PTCA w/out stent ($): 11957] [Stereotactic Radiosurgery ($): 19177] [Stereotactic Radiosurgery-Fractionated ($): 660] [Observation ($): 5124] [ED Level 1--99281 ($): 984] [ED Level 2--99282 ($): 1099] [ED Level 3--99283 ($): 1274] [ED Level 4--99284 ($): 1582] [ED Level 5--99285 ($): 1582] [Critical Care ($): 1736] [Urgent Care ($): 364] [Clinic Visit ($): 64] [Cardiac Rehabilitation Therapy ($): 330] [Cardiac Stress Test ($): 556] [Cardiology ($): 669] [Echocardiology ($): 571] [EKG/ECG ($): 642] [Electrophysiology Ablation ($): 16376] [Electrophysiology and Mapping Studies ($): 10407] [Holter Monitor/Telemetry ($): 652] [Peripheral Vascular Lab ($): 281] [EEG ($): 699] [EMG ($): 592] [MEG ($): 1588] [Neuropsychological Testing and Biofeedback ($): 406] [Sleep Studies-Attended ($): 1224] [Sleep Studies-Unattended ($): 298] [Chemotherapy ($): 1355] [Nuclear Medicine ($): FEE SCHEDULE] [Oncology ($): 1091] [Radiation Therapy ($): 3571] [CT Scan OP ($): FEE SCHEDULE] [MRI OP ($): FEE SCHEDULE] [Imaging Services ($): FEE SCHEDULE] [Mammography-Diagnostic Fee Schedule: FEE SCHEDULE] [Mammography-Screening Fee Schedule: FEE SCHEDULE] [Positron Emission Tomography ($): FEE SCHEDULE] [Radiology Fee Schedule: FEE SCHEDULE] [Ultrasound Imaging ($): FEE SCHEDULE] [Laboratory Fee Schedule: FEE SCHEDULE] [Pathology Fee Schedule: FEE SCHEDULE] [Hemodialysis ($): 383] [Peritoneal Dialysis, CAPD, and CCPD ($): 383] [Occupational Therapy ($): 203] [Physical Therapy ($): 202] [Resp. Services/Therapy ($): 331] [Speech Therapy ($): 204] [OP High Cost Drugs ($): FEE SCHEDULE] [Hyperbarics ($): 1784] [IV Therapy ($): 422] [Pulmonary Function ($): 446] [Pulmonary Rehabilitation ($): 330] [All Other OP (%BC): 35]","count":"87","median_amount":540.77,"10th_percentile":540.77,"90th_percentile":1086.69,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Outpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[APC ($): FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hypertensive Encephalopathy With Mcc","code_information":[{"code":"077","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hypertensive Encephalopathy With Cc","code_information":[{"code":"078","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Hypertensive Encephalopathy Without Cc/Mcc","code_information":[{"code":"079","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Cardiac Pacemaker Device Replacement With Mcc","code_information":[{"code":"258","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":18871.32,"maximum":24060.93,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23589.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23589.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23589.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24060.93,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23589.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23589.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":18871.32,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":23589.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23589.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23589.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":23589.15,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Cardiac Pacemaker Device Replacement Without Mcc","code_information":[{"code":"259","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":12144.65,"maximum":15484.43,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15180.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15180.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15180.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15484.43,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15180.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15180.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12144.65,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15180.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15180.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15180.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15180.81,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Cardiac Pacemaker Revision Except Device Replacement With Mcc","code_information":[{"code":"260","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24116.45,"10th_percentile":24116.45,"90th_percentile":24132.23,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":19536.18,"maximum":24908.63,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24420.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24420.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24420.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24908.63,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24420.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24420.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19536.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24420.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24420.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24420.23,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24420.23,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Cardiac Pacemaker Revision Except Device Replacement With Cc","code_information":[{"code":"261","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13713.36,"10th_percentile":13713.36,"90th_percentile":13713.36,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":11354.26,"maximum":14476.69,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14476.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":11354.26,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":14192.83,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc","code_information":[{"code":"262","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25224.0,"10th_percentile":25224.0,"90th_percentile":25224.0,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":9789.11,"maximum":12481.12,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12236.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12236.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12236.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12481.12,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12236.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12236.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9789.11,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":12236.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12236.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12236.39,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":12236.39,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Other Circulatory System O.R. Procedures","code_information":[{"code":"264","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14787.53,"10th_percentile":14787.53,"90th_percentile":14787.53,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":47603.55,"10th_percentile":47603.55,"90th_percentile":47603.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24818.74,"10th_percentile":24818.74,"90th_percentile":24818.74,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":24302.37,"10th_percentile":24302.37,"90th_percentile":24302.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":20063.5,"maximum":25580.97,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25079.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25079.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25079.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25580.97,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25079.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25079.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":20063.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":25079.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25079.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25079.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":25079.38,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Deep Vein Thrombophlebitis With Cc/Mcc","code_information":[{"code":"294","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Deep Vein Thrombophlebitis Without Cc/Mcc","code_information":[{"code":"295","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Combined Anterior And Posterior Spinal Fusion With Mcc","code_information":[{"code":"453","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Combined Anterior And Posterior Spinal Fusion With Cc","code_information":[{"code":"454","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc","code_information":[{"code":"455","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Fusion Except Cervical With Mcc","code_information":[{"code":"459","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Spinal Fusion Except Cervical Without Mcc","code_information":[{"code":"460","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Revision Of Hip Or Knee Replacement With Mcc","code_information":[{"code":"466","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":38595.55,"10th_percentile":38595.55,"90th_percentile":38595.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":31263.42,"maximum":39860.86,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39079.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39079.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39079.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39860.86,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39079.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39079.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":31263.42,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":39079.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39079.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39079.27,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":39079.27,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Revision Of Hip Or Knee Replacement With Cc","code_information":[{"code":"467","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26146.44,"10th_percentile":26146.44,"90th_percentile":26196.3,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":96241.1,"10th_percentile":86620.55,"90th_percentile":116713.65,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26148.84,"10th_percentile":26146.44,"90th_percentile":26158.44,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":49421.77,"10th_percentile":49421.77,"90th_percentile":49421.77,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":25691.18,"10th_percentile":25691.18,"90th_percentile":25691.18,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":21180.62,"maximum":27005.29,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26475.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26475.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26475.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27005.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26475.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26475.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21180.62,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26475.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26475.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26475.77,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26475.77,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Revision Of Hip Or Knee Replacement Without Cc/Mcc","code_information":[{"code":"468","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20413.35,"10th_percentile":20413.35,"90th_percentile":20413.35,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":86684.15,"10th_percentile":84719.27,"90th_percentile":87780.45,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":19285.89,"10th_percentile":19285.89,"90th_percentile":19285.89,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":20381.85,"10th_percentile":20381.85,"90th_percentile":20381.85,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":16504.38,"maximum":21043.08,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20630.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20630.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20630.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":21043.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20630.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20630.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":16504.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":20630.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20630.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20630.47,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":20630.47,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Knee Procedures With Principal Diagnosis Of Infection With Mcc","code_information":[{"code":"485","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":19381.83,"maximum":24711.84,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24227.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24227.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24227.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24711.84,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24227.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24227.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":19381.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":24227.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24227.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24227.29,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":24227.29,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Knee Procedures With Principal Diagnosis Of Infection With Cc","code_information":[{"code":"486","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":12559.06,"maximum":16012.81,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15698.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15698.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15698.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":16012.81,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15698.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15698.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12559.06,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15698.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15698.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15698.83,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15698.83,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Knee Procedures With Principal Diagnosis Of Infection Without Cc/Mcc","code_information":[{"code":"487","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26637.64,"10th_percentile":26637.64,"90th_percentile":26637.64,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":15710.55,"10th_percentile":15710.55,"90th_percentile":15710.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":9406.54,"maximum":11993.33,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11758.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11758.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11758.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11993.33,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11758.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11758.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":9406.54,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11758.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11758.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11758.17,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11758.17,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Arthroscopy","code_information":[{"code":"509","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc","code_information":[{"code":"736","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":53349.41,"10th_percentile":53349.41,"90th_percentile":53349.41,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":21468.3,"maximum":27372.08,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26835.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26835.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26835.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27372.08,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26835.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26835.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21468.3,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26835.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26835.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26835.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26835.37,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc","code_information":[{"code":"737","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":28613.55,"10th_percentile":27134.95,"90th_percentile":29363.55,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":26633.26,"10th_percentile":26633.26,"90th_percentile":26633.26,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":15293.42,"10th_percentile":15293.42,"90th_percentile":15293.42,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":12375.88,"maximum":15779.25,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15469.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15469.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15469.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15779.25,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15469.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15469.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":12375.88,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":15469.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15469.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15469.85,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":15469.85,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/Mcc","code_information":[{"code":"738","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17934.96,"10th_percentile":17934.96,"90th_percentile":17934.96,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":8819.75,"maximum":11245.18,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11024.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11024.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11024.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11245.18,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11024.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11024.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8819.75,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":11024.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11024.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11024.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":11024.69,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Mcc","code_information":[{"code":"739","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":26597.19,"10th_percentile":26597.19,"90th_percentile":26597.19,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":21518.15,"maximum":27435.64,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26897.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26897.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26897.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":27435.64,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26897.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26897.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":21518.15,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":26897.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26897.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26897.69,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":26897.69,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Cc","code_information":[{"code":"740","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":14209.07,"10th_percentile":14209.07,"90th_percentile":14209.07,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":13424.49,"10th_percentile":13424.49,"90th_percentile":13424.49,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":10868.38,"maximum":13857.19,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13585.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13585.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13585.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13857.19,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13585.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13585.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":10868.38,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":13585.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13585.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13585.48,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":13585.48,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy Without Cc/Mcc","code_information":[{"code":"741","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"1 through 10","median_amount":17711.08,"10th_percentile":17711.08,"90th_percentile":17711.08,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"1 through 10","median_amount":10696.24,"10th_percentile":10696.24,"90th_percentile":10696.24,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"1 through 10","median_amount":19985.37,"10th_percentile":19985.37,"90th_percentile":19985.37,"additional_payer_notes":"Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer's algorithm."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]},{"setting":"inpatient","billing_class":"facility","minimum":8565.1,"maximum":10920.5,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10706.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10706.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10706.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10920.5,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10706.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10706.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":8565.1,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"fee schedule","standard_charge_dollar":10706.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10706.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10706.37,"additional_payer_notes":"MSDRG Base Rate"},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":10706.37,"additional_payer_notes":"MSDRG Base Rate"}]}]},{"description":"Principal Diagnosis Invalid As Discharge Diagnosis","code_information":[{"code":"998","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Ungroupable","code_information":[{"code":"999","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","billing_class":"facility","payers_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 118525 | Excess % of Charge: 42] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 9792 Days: 3 Additional Days: 1679] [Normal vag. Del. 2 day stay-Case Rate: 7973 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Vag. Del. w Sterilization/D&C w/o CC/MCC-Case Rate: 8394 Days: 2 Additional Days: 1679] [Normal Newborn-Per Diem: 924] [Nursery  Level 2-Per Diem: 3230] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 1082 (%BC): 35]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"AvMed","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 103991 | Total % of Charge: 50] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 3 day stay-Case Rate: 4847 Days: 3 Additional Days: 1154] [Normal vag. Del. 2 day stay-Case Rate: 3447 Days: 2 Additional Days: 1154] [Normal Newborn-Per Diem: 524] [IP High Cost Drugs ($): 0 Charge Threshold 500 (%BC): 60] [IP Prosthetics/Implants/Devices ($): 0 Charge Threshold 500 (%BC): 60]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 148035 | Total % of Charge: 40] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Total Charges > 200000 | Total % of Charge: 41.2] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9672 Days: 4 Additional Days: 2246] [Normal vag. Del. 2 day stay-Case Rate: 6587 Days: 2 Additional Days: 2246] [Nursery  Level 1- Boarder-Per Diem: 1281] [Nursery  Level 2-Per Diem: 3095] [Nursery  Level 3-Per Diem: 3095] [Nursery  Level 4-NICU-Per Diem: 3076] [IP High Cost Drugs (%BC): 15.6] [IP Prosthetics/Implants/Devices (%BC): 22.4]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","methodology":"percent of total billed charges","standard_charge_percentage":70.0,"count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","methodology":"other","standard_charge_algorithm":"[Stop Loss: Length of Stay > FeeSchedule days | Excess Per Diem: 7458] [Lesser Than Charges paid at %: 100] [MSDRG Base Rate: FEE SCHEDULE] [C-Section 4 day stay-Case Rate: 9322 Days: 4 Additional Days: 1294] [Normal vag. Del. 2 day stay-Case Rate: 7266 Days: 2 Additional Days: 1294] [Nursery  Level 1- Boarder-Per Diem: 1099] [Nursery  Level 2-Per Diem: 3119] [Nursery  Level 3-Per Diem: 3123] [Nursery  Level 4-NICU-Per Diem: 3130]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","methodology":"other","standard_charge_algorithm":"[Inpatient Services: Payer leverages state specific Medicaid payment methodology. Available, referenceable algorithm logic found here: https://ahca.myflorida.com/medicaid/]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","methodology":"other","standard_charge_algorithm":"[MSDRG Base Rate: FEE SCHEDULE]","count":"0","additional_payer_notes":"No services performed during 15-month lookback period."}]}]},{"description":"Prsnlz trgt dvl arhfcmrigtbs","code_information":[{"code":"0889T","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","minimum":777.24,"maximum":990.97,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":971.54,"additional_payer_notes":"APC"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":990.97,"additional_payer_notes":"APC"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":777.24,"additional_payer_notes":"APC"}]}]},{"description":"Brachytx, non-str,Yttrium-90","code_information":[{"code":"C2616","type":"HCPCS"}],"standard_charges":[{"setting":"outpatient","billing_class":"facility","minimum":14216.81,"maximum":18126.43,"payers_information":[{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":17771.01,"additional_payer_notes":"APC"},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","methodology":"fee schedule","standard_charge_dollar":18126.43,"additional_payer_notes":"APC"},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","methodology":"fee schedule","standard_charge_dollar":14216.81,"additional_payer_notes":"APC"}]}]},{"description":"Rem mlt day uroflow 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Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"Services delivered under an outpatient speech language pathology plan of care","code":"GN","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"AvMed","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Community Care Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare/Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medigap","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"New Century Health","plan_name":"Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Simply Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Simply Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Sunshine Health","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Sunshine Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthcare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."}]}]}